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Attachment 2
NOTICE
_ OFFENDER NOTARY PUBL]C SERVICE
Under both Federal law (28 U.S.C § l746) and State law (V.T.C.A. Civil Practice & Remedies
Code, §l32.00l-l32.003), offenders incarcerated in Texas may use an unsworn declaration under
penalty of perjury in place of a written declaration, verification, certification, oath, or affidavit
sworn before a Notary Public.
ln a request for Notary Public service, each offender must explain why an Unsworn Declaration is
insufficient before Notary Public service will be provided. ' '
******************************************************************************
An example of an unsworn declaration pursuant to State law is as follows.'
"My name is Qlal\?h (’)\ "_' (hfdbn& my date ofbirtli is g ai § g Q ,
(First) (Middle) (Last)
and my inmate identifying number, is \\_“\H _\;\LQ``Z'L . l am presently incarcerated in
D<\\ QLE)\ \&t\.\‘& ~< ``T'-‘O.Q,,§ in \bboC\ QC\,\“'\C
`` . (Corrections unit name) _ (City)
\)¢\CXI\'\\’U\ ’Y€.¥£LS Ul£r? . I declare under penalty of
(County) » (State) (Zip Code)
perjury that the foregoing is true and correct
Executed on the \ \Abday of >g,v\ gi ' , 20
***************************************************
An example of an unsworn declaration pursuan/ to Federal law is as follows.'
**** **********************
(insert offender name and TDC.l number), ``being
(insert TDCJ unit name), in
County, Texas, declare under penalty of perjury that the foregoing is true
l
presently incarcerated in
and correct
_ Executed on the , day of ' , 20 .
' (Offender Signature)
***********************************************$**************************#***
NOTICE
NOTARY PUBLIC SERVICE DENIAL
insufficient justification 'was provided
Regarding your request for Notaiy Public service,
proceed with an Unsworn Declaration.
necessitating Notary Public service. l~lowever, you may
t"_\>»s~ \'>\
