STATE OF MONTANA COUNTY OF ___ RETURN TO: MONTANA DEPARTMENT OF LIVESTOCK PO BOX 202001 HELENA, MT 59620-2001
___, BEING FIRST DULY SWORN, DEPOSES AND SAYS; THAT (HIS) (HER) MAILING ADDRESS IS: ___
COUNTY OF ___, STATE OF MONTANA;
AND THAT _____ AND ___
ARE ONE AND THE SAME PERSON.
THIS AFFIDAVIT IS SUBMITTED ON ORDER THAT THE RECORDS OF THE RECORDER OF MARKS AND BRANDS OF THE STATE OF MONTANA MAY BE CORRECTED AND A DUPLICATE CERTIFICATE ISSUED AS EVIDENCE THEREOF.
DRAW BRAND HERE
POSITION ON CATTLE
POSITION ON HORSES
POSITION ON SHEEP PAINT COLOR
POSITION ON OTHER (SPECIFY)
___
SIGN PRESENT NAME: ___
DATE: ___
STATE OF MONTANA COUNTY OF ___ SIGNED BEFORE ME ON ___ BY ___
SIGNATURE OF NOTARY ___
MONTANA NOTARIES MUST COMPLETE THE FOLLOWING IF NOT PART OF STAMP AT LEFT:
PRINTED NAME OF NOTARY ___
NOTARY PUBLIC FOR THE STATE OF ___
RESIDING AT___
(AFFIX NOTARIAL SEAL/STAMP ABOVE)
MY COMMISSION EXPIRES ___ - 20