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Notarized Identity Verification PRINT NAME First Name Middle Initial Last Name E-mail Address optional Address City State Zip Code I hereby represent that all above information is true and accurate. Signature Sign in the Presence of a Notary State of County of I hereby certify that on this day of 20 Personally appeared before me the signer and subject of the above form who signed or attested to the same in my presence and presented the following form of identification as proof of his or her...
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(optional) * Please confirm the information provided is accurate! A photo ID can be a driver's license, a state-issued ID card or an employee ID. If you want more than one form of photo ID, please see your local DMV or call our office to get special instructions. Please Note: Any questions or concerns please call us at (602) 534-5373 or email us. We are open for business 7 days a week, 7:00 A.M. to 6:30 P.M. Eastern Daylight Time. Customer Comments Customer Feedback Thanks for contacting VET-PTSD. We hope this information is useful to you. If you would like to discuss our services with our staff, we have a friendly customer service number for all our offices: (541) 324-6767. You need to provide our representative with your name, your home phone number, and your business email address. We will respond to your inquiry as soon as we can, but please allow up to four weeks for the response to be received. Please expect a response within 24 to 48 hours. Your email address is confidential, and will not be disclosed to any third parties. If you are concerned about your privacy, you may elect to view or print a copy of your transaction through our secure website. If you choose to do so, we may retain or distribute that information to the parties involved in the transaction for our own record keeping purposes. We recommend that you save a copy of this email communication for your records. By clicking the 'Submit' button below, I acknowledge that I have read the terms and conditions of this site and understand that I can request access to record details of my transaction in regard to this transaction by contacting the customer service department for this office or by telephone at (602) 534-5373 (Extension: 5373). If you have any questions about our privacy/security practices in regard to the information you submit through this site, please contact us at (602) 534-5373. You are sending your written request (or request via e-mail) to: VET-PTSD Customer Service Attention: VET-PTSD Client Services 1725 N 6th St P.O. Box 92586 Springfield, MO 65806 Your request will be sent via email. If this is an initial request for