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NOTICE OFFENDER NOTARY PUBLIC SERVICE Under both Federal law (28 U.S.C § 1746) and State law (V.T.C.A. Civil Practice & Remedies Code, § 132.00 1-132.003), 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.

In a request for Notary Public service, each offender must explain why an Unsworn Declaration is , ·-·- -. _jg~pJ.fi.c;i~ntb.e_fgr~,Notary Public. s~wi_ce .will b_e,provided. ····'----'···· __ _ .· .· . . .... _·_ .· .. . ...

****************************************************************************** An example of an unsworn declaration pursuant to State law is as follows:

"My name is ll1'-AQU l?£,Ma'{U€ ~\~~ my date ofbiJth is oc:-q~ 7~ (First) (Middle) (Last) and my inmate identifying number, is \~"31q'-\.'3 . I am presently incarcerated in

n- .. ,\'c (Cor~~s unit name) (City} _co=...:."-~=---'"'-,-----\"-"" -t:i"-,___f\--=--~=-----~-L~f> ....Su.•.~--)l"-0=----,--· I declare under penalty of (County) (State) (Zip Code) perjury that the foregoing is true and correct.

Executed on the 7<\ day of UClV'UClf\(= , 20 \'5'. ~OJ W~b, t.ti'- (Offender Signature) -~*************************************************************************** n example of an unsworn declaration pursuant to Federal law is as

and correct.

_ _ _ day of._ _ _ _ _ _ , 20_.

. **************************************************************************** NOTICE NOTARY PUBLIC SERVICE DENIAL SUB.JECT: State briefly the problem on which you desire assistance.

Name: (DMQk{ \(lj{WR{ No: lg3/C(Q3 Unit: lE(fOaJ BU- 4 2 Living Quarters: ') War'< Msignment: ME"Q-~ 5 .

DISPOSITION: (Inmate w;JI not w,;te ;nth;, 'pace) d D {) ~t VMill (039G ~~·~( n y . \DVvll -trl-60 (Rev. 11-90)