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NC Authentication Office Cover Letter
(Oficina de Authentications del Estado de Carolina del Norte)
Telephone Number: 919-807-2140 Email Address:[email protected]
(Numero de telefono) (Direcci6n de correo electr6nico)
Mailing Address for US Postal Service Mail: Street Address for Carrier and hand Delivery Mail: (Correo Regular): (Correo rapido):
Authentication Office Authentication Office NC Secretary of State NC Secretary of State PO Box 29622 2 South Salisbury St Raleigh NC 27626-0622 Raleigh NC 27601-2903
Date (Fecha de Hoy Dia): _____________
Contact Name (Nombre y apellido del solicitante): _________________
Address (Direcci6n): _________________________
City (Ciudad):. ________ State (Estado): ___ Zip (C6digo Postal} ____
Daytime Telephone Number (Numero de telefono): _______________
Country Each Document will go to (Pais en que se propone usar): ___________
Special Notes or Instructions (Notas Especiales 0 Instrucciones Especiales):
Number of Documents (Cuantos Documentos)
x $10.00 = $
Adoptions Only (Solo para adopci6n) Duplicate Originals (Duplique las Originales)
x$5.00 = $
Total Payment enclosed: (Total de pago) $
Check Number (Numero de cheque):
Cash (Efectivo)
Money Order (Giro postal)
Cashier's Check (Cheque de la gerencia)
Return Documents By: (EI regreso documentos por):
__Self-Addressed Stamped Envelope (Correo Regular: Sobre con la direcci6n de uno mismo con franqueo pagado)
__ Overnight Delivery Envelope or Label (Must have account number pre-printed by the delivery company or have pre-paid postage stamp from the delivery company) (Correo Rapido (Fed-Ex, UPS): Sobre con la direcci6n de uno mismo con franqueo pagado)
__ Pick-Up (Regres6 para recoger los documentos)
mailto:Address:[email protected]