La Jolla Mobile Notary serving San Diego County

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(858) 224-2519


888 Prospect Street, Ste. 200

La Jolla CA 92037

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California jurat with affiant statement

California jurat with affiant statement

There are two options

Option one: to be inserted into a document that needs to be notarized. First save the following jurat, next open your word document put the cursor where you would like the jurat to go then insert > image.

California Jurat Notary

California Jurat Notary

Option 2: California Jurat to be attached to a document

jurat with affiant statement

jurat with affiant statement

For Notary instructions

Check the first box if this Jurat

certificate is going to be attached to

another document. If so, then cross

out lines 1–6 on the certificate. Check the

second box if the affiant is going to

use this form to make a statement.


are provided for the affiant to complete

his or her own statement, and should

not be completed by the Notary. If

affiant is not using this certificate to

make a statement, lines 1–6 should be

crossed out by the Notary.


This is signed by the person(s) who

completed the statement in lines 1–5.

If an attached document is signed

instead, these spaces should be lined

through by the Notary.

NAME OF COUNTY where Notary

performs notarization.


Actual day, month and year in which

the document signer appears before

Notary to sign this certificate or an

attached document and take an oath or affirmation.

NAME(S) OF AFFIANT SIGNER(S) name(s) signed before the Notary.

Initials and spelling of the name(s) should agree with the document, ID card, and

journal signatures. If only one signer is appearing before the Notary, cross

out any remaining space.

SIGNATURE OF NOTARY, exactly as name appears on

commissioning papers and in the seal.


and legibly affixed.


If no other format is prescribed, this form may be used when an

the individual is signing and swearing (or affirming) that certain written

statements are true.

The text space provided (lines 1–5) are available for a document signer

to type or neatly print (in ink) a written statement. This portion of the

certificate should not be completed by the Notary. A person completing

any of lines 1–5 must sign this form on line 6 in the presence of the

Notary, who would also administer an oath or affirmation.

If this form is to be attached to another document, then the Notary

should cross out lines 1–6. The signer would affix a signature on the

attached document, not on this certificate, in the Notary’s presence.

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