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Certified Identity Confirmation samples

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ACERTIFYING OFFICI<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

Certifying official must<br />

<br />

write the CURRENT date.<br />

SAMPLE OF THE<br />

<br />

<br />

<br />

<br />

<br />

<br />

Certifying<br />

official’s seal,<br />

stamp or signature<br />

must overlap on<br />

the photo and on<br />

the form.<br />

<br />

<br />

<br />

<br />

<br />

<br />

L • LEGAL SEAL •<br />

<br />

<br />

<br />

All information<br />

must be provided<br />

by the certifying<br />

official.<br />

<br />

Applicants MUST sign here.<br />

<br />

<br />

<br />

<br />

<br />

.<br />

<br />

<br />

<br />

To be left<br />

<br />

BLANK for<br />

STUDENT<br />

<br />

applicants.<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

Second<br />

identical photo<br />

required here<br />

attached with<br />

one piece<br />

of scotch tape.<br />

Applicants MUST sign here.<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

.<br />

This second photo<br />

SHOULD NOT be<br />

certified; ONLY<br />

the above photo.


AL • LEGAL SEAL •<br />

CERTIFICATION SAMPLE — PASSPORT<br />

Certifying official’s<br />

contact information.<br />

Mr./Ms. Certifying Official<br />

123 Any Street, Anycity, Anycountry<br />

certifyingofficial@server.com<br />

tel.: 613-555-5555<br />

Certifying<br />

official’s seal<br />

or stamp.<br />

I<br />

CERTIFYING OFFIC<br />

I certify this<br />

photocopy to be a true<br />

copy of the original<br />

document<br />

January 1, 2013<br />

Certification<br />

MUST include the words<br />

“true copy of the original”.<br />

Certifying official’s SIGNATURE.<br />

DATE of certification.<br />

MCC | Certification Sample - Passport

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