Request For Authentication
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Request For Authentication Form. This is a Oregon form and can be use in Notary Secretary Of State.
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Tags: Request For Authentication, 516, Oregon Secretary Of State, Notary
Phone: (503) 986-2593
Fax: (503) 986-2300
Request for Authentication
Notary
Secretary of State - Corporation Division - 255 Capitol St. NE, Suite 151 - Salem, OR 97310-1327 - http://www.FilingInOregon.com
All Sections Must Be Completed
Country documents will be used in:
My documents were ordered from Oregon State Vital Records on:
Authenticate my enclosed document(s).
REQUESTER INFORMATION:
Name of Requester:
Mailing Address:
U.S. Area code and Phone Number:
(This office cannot make international calls)
Email Address:
METHOD OF PAYMENT: Required $10.00 fee per document.
Make check payable to “Corporation Division.”
Do Not fax documents that require authentication - we can not Authenticate Faxed documents.
VISA or MasterCard #:
Expiration Date:
Cardholder Name:
Billing Address:
City, State, Zip Code:
Phone Number:
Business Name:
DELIVERY SERVICE:
USPS First Class Mail (Self-addressed, stamped envelope must be provided.)
Overnight/Express Service Delivery (A prepaid Air Bill must be provided.)
If you do not provide a return envelope, documents will be returned by standard USPS mail.
516 (08/09)
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