DECLARATION OR CERTIFICATION UNDER
PENALTY OF PERJURY
My name is:
Identification type:
If other, Please specify:
Issuing
Authority:
If other, Please specify:
Identification Number:
Expiration
Date:
The
identification information I have provided to
UpRisers Incorporated,
$50 Online, Self Study and
Instructor-led Courses, California
approved
notary
education vendor, is correct and
accurately identifies me.
I have
personally and fully completed the approved
6 (six)
hour course of study
offered by
UpRisers Incorporated regarding the
laws and regulations that apply
to California
notaries public. This includes reading and
reviewing for at least 6
(six)
hours the course materials and taking any
practice exams included as part of the course.
I completed the 6(six) hour course of study on:
DATE:
I understand
that the crime of perjury is punishable by
imprisonment in the state prison
for two, three or
four years. Penal Code § 126
I declare or certify under penalty of perjury under the laws of the State of California
that the foregoing is true and correct.
TODAY'S DATE:
Note: You
must submit this declaration of certification in
order to
receive your proof of completion to
satisfy the Secretary of State mandatory
6 hour
course completion. The declaration or
certification must be delivered, mailed, faxed or
electronically transmitted to UpRisers
Incorporated. Once you
fax, email, mail, submit or deliver this form, you
will be given a proof of
completion to satisfy the
Secretary of State’s 6 (six) hour requirement.
Number where we can contact you:
Your email address (if applicable):
Mailing address:
City
State
Zip
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