← fa0b9d76-1215-44b4-bfa0-3e86ae00e157_namechangeaffidavit-artifacted.pdf
Rebuilt HTML — PaddleOCR-VL (Baidu)
Content placed at each item's bbox to mirror the original PDF layout (font sizes are estimated). overlay · view JSON
Page 1
Download HTML
AFFIDAVIT OF CHANGE OF NAME
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