STATE CERTIFICATION APOSTILLE or AUTHENTICATION REQUEST FORM 1. The document(s) is/are being certified for the country of: 2. Please include a self-addressed stamped envelope for the return of the documents. 3. Complete your contact information: Name (Area Code) Phone Number Address City State Zip Code E-Mail Address Signature Date Filing Fee: $10.00 per document Enclosed is a check or money order for $ to cover the cost of documents. Make payable to Secretary of State and mail your request to: SECRETARY OF STATE NOTARY AND CERTIFICATION SERVICES PO BOX 202801 1301 6TH AVENUE HELENA MT 59620-2801 If you have any questions please visit our website www.sos.mt.gov/Notary Contact us at (406) 444-1877 or sosnotary@mt.gov American LegalNet, Inc. www.FormsWorkFlow.com