Phone: (503) 986-2593 Fax: (503) 986-2300 Secretary of State - Corporation Division - 255 Capitol St. NE, Suite 151 - Salem, OR 97310-1327 - http://www.FilingInOregon.com Request for Apostille/Authentication Notary All Sections Must Be Completed Country documents will be used in: Apostille/Authenticate my enclosed document(s). OR, my document(s) are being mailed from: Type of document(s). Name(s) on document(s). REQUESTER INFORMATION: Name of Requester: Mailing Address: U.S. Area code and Phone #: (This office cannot make international calls) Email Address: METHOD OF PAYMENT: Required $10.00 fee per document. Make check payable to "State of Oregon" or "Corporation Division" or fax this request with payment by VISA or MasterCard to 503-986-2300. Do NOT fax documents that require apostille/authentication. We cannot authenticate faxed documents. VISA or MasterCard #: Cardholder Name: Billing Address: City, State, Zip Code: Phone Number: Business Name: DELIVERY: Pick up in person. Expiration Date: USPS First Class Mail (self-addressed, stamped envelope is provided.) For all overnight/express service delivery, a prepaid airbill must be provided. (A credit card or account number is NOT sufficient for overnight/express service.) 516 (02/11) American LegalNet, Inc. www.FormsWorkFlow.com