Act of Expatriation TEMPLATE
Act of Expatriation TEMPLATE
Cassandra-Grace: Chatham
c/o 1200 Masonic Ave, # 3
San Francisco, California Republic [Postal Code Exempt – D.M.M. 602, 1.3 (e)(2)]
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Cassandra-Grace: Chatham, Attorney in Fact
1
ACKNOWLEDGEMENT / NOTARY
On this _______day of ___________, 2022, before me, the undersigned, a Notary Public in and
for San Francisco County, personally appeared the above-signed, known to me to be the one
whose name is signed on this instrument, and has acknowledged to me that she has executed the
same.
My commission expires:__________________________