Please print, then mail or fax this page to American Schools. Your order is not complete and you will not be considered as registered, without the school having received this Declaration of Identification and the required photo ID photocopy!

DECLARATION OF IDENTIFICATION OR CERTIFICATION UNDER PENALTY OF PERJURY

My name is (name of student) __________________________________________

The photo identification information I have provided, together with this signed form, to California Secretary Of State Notary Education Course Vendor #601345, American Schools - ONLINE, PO Box 5161, Torrance, Ca. 90510, Fax: 310-377-0511, is correct and accurately identifies me. The photocopy of the identification document sent with this Declaration is that of my (check one) ____ Driver License, ___ Passport, No. ______________,

issued by the State / Country of ________________, Expiration Date: _____.

I understand that the crime of perjury is punishable by imprisonment in the state prison for two, three or four years (Penal Code § 126.)

 
 I declare or certify under penalty of perjury under the laws of the State of California that the 
 foregoing is true and correct.
 
 Executed on _______________at ___________________, California
 
 
 
 _______________________________
 
 (Signature of Student)
 
Please type Student’s Name _________________________________
 
Student’s Mailing Address__________________________________

 
Phone:_____________________; Fax: __________________________;
 
Email Address: ____________________________________________.