Free facsimco.p65 - West Virginia

AFFIDA COUNTY, MUNICIPAL, OTHER AFFIDAVIT OF COUNTY, MUNICIPAL, OR OTHER PUBLIC OFFICIAL ESTABLISHING FA SIGNA ESTABLISHING FACSIMILE SIGNATURE
STATE OF WEST VIRGINIA COUNTY OF , To-wit: , after being first duly sworn by the undersigned Clerk of the County Commission, on oath, deposes, says and certifies: 1. of the State of West Virginia. 2. That in order to establish a facsimile signature to be used in lieu of his or her manual signature, as authorized by Chapter 6, Article 14, of the Code of West Virginia of 1931, as amended, he or she hereunto affixes his or her manual signature to this affidavit form and authorizes the same to be certified to and filed with the Secretary of State of West Virginia. 3. That his or her term of office ends as of Signature I, Clerk of the County Commission of County, West Virginia, do hereby certify that the affiant named above, who is well known to me, personally appeared before me this day and made oath as noted above, and affixed his or her manual signature to the above affidavit; that the affiant does, in fact, as of this day occupy the official office, with specified term as aforesaid. Witness my hand and seal of office this day of (SEAL) Clerk of the County Commission of County, West Virginia , . That he or she is (Title) , a political subdivision of

I, Commission of sion of said County.

, do certify that I am the President of the County County, and that

whose name appears above, is of this date the duly qualified and acting Clerk of the County Commis-

President of the County Commission of Date County, West Virginia

CERTIFICA TIFICATE SECRETAR ARY STA CERTIFICATE OF SECRETARY OF STATE STATE OF WEST VIRGINIA,

I, , Secretary of State of West Virginia, do hereby certify that, inasmuch as the foregoing Facsimile Signature Affidavit appears to be properly executed with manual signature, and is duly authenticated, the same is hereby this day declared approved, filed and admitted to record in my office in the State Capitol, and the manual signature affixed by the affiant to above affidavit may be reproduced as the facsimile signature of an authorized officer by engraving, imprinting, stamping or other means, as authorized by Chapter 6, Article 14, of the Code of West Virginia, 1931, as amended, during the term of his or her said office as aforesaid.

In Witness whereof, I have subscribed my signature, and caused the Great Seal of the State to be affixed day of , hereto this
(Seal)

Secretary of State

PRINT THIS COPY, THEN CLICK HERE TO RESET.