COMMONWEALTH OF KENTUCKY

MICHAEL ADAMS, SECRETARY OF STATE

Division of Corporations

Business Records

P.O. Box 718

Frankfort, KY 40602

(502) 564-3490

(502) 564-5687 (fax)

www.sos.ky.gov

Request for Apostille or Authentication

This document is being certified for use in the country of

Number of documents enclosed needing certification

Total amount enclosed ($5.00 per Apostille/Authentication):

Checks should be made payable to the Kentucky State Treasurer.

Requesters Contact Information:

Name (Please print)

Mailing Address

City

State

Zip Code

Phone Number

Where Apostillized or Authenticated Documents Should Be Mailed:

Name (Please print)

Mailing Address

City

State

Zip Code

Phone Number

Must check one

The attached document is county clerk certified.

The attached document is certified by the current state registrar (from Vital Statistics).

You must enclose the document to be authenticated or apostillized with this request.

(02/20)

Shipping Options

I have my own shipping account. I will upload my digital prepaid shipping label (FedEx, UPS, USPS, or DHL) in PDF format

I would like to buy a 2 days FedEx envelop to ship and return my documents for a fee of $10.00 each. A total of: $20.00

I would like to buy a Next day FedEx envelop to ship and return my documents for a fee of $25.00 each. A total of: $50.00

Shipping from my address to

ORIGIN ID:GBOA

UNITED STATES

ACTVVGT: 0.20 LB

CAD:119084289/WSXI3400

BILL SENDER

TO

,

REF:

INV:

PO: DEPT:

5678FGH657

TRK#
0201

7946 3014 0400

SE GBOA

Thu - 10 Sep

** 1,2 DAYS **

- US

Shipping from to my address