This document appears to be a notarized statement or certification. It includes a space for the official seal and the date, which is left blank. The signature of the Notary Public is also required. The document is issued by the State of Florida and is applicable throughout the state. The Notary Public's name should be printed, typed, or stamped on the document. The notary confirms that the person mentioned in the document is either personally known to them or has produced identification. The type of identification produced is also mentioned. The document indicates that the person mentioned either took an oath or did not take an oath. The document is the last page, numbered as page 76 out of 76.