Conway, NH · Carroll County
Confidentiality Statement
This statement records that a person received, read, and agreed to follow Town of Conway confidentiality regulations for information about clients or former clients.
- licensed online notary
- ~15 min average
- Notarized PDF emailed
What you’ll need
- Government-issued photo ID
- Webcam-enabled device (laptop or phone)
- This form, ready to upload as a PDF
What this form is
The statement sets out confidentiality obligations for Town of Conway staff, including employees and volunteers, who may learn information about clients or former clients. The signer confirms receiving a copy of the town’s regulations, understanding them, and agreeing to abide by them. Use it when the town asks a staff member or volunteer to document that commitment; the form also includes a notarial acknowledgment.
Who needs it
A Town of Conway staff member or volunteer asked to confirm receipt and understanding of the town’s confidentiality regulations needs this form.
Why it needs a notary
The form carries an acknowledgment before an officer; the person named as signer personally appears and acknowledges executing the statement before the notary or Justice of the Peace.
How to get this notarized
- 1
Download the Form
Get the Confidentiality Statement from the Town of Conway.
- 2
Fill In the Form
Enter the requested information and read the confidentiality terms. Leave the signature for the notarization appointment.
- 3
Book an Online Notary
Schedule a session with a commissioned online notary and have the form ready.
- 4
Sign on Video
Personally appear before the notary, acknowledge signing the statement, and complete the acknowledgment.
- 5
Submit to the Town
Send or deliver the completed form to the Town of Conway as instructed.
Preview the form
The blank PDF straight from Conway. Look it over, then upload your filled copy to start the notary session.
You’ll need ID and a webcam.
A licensed online notary will join you on video, verify your government-issued ID, witness your signature, and apply their seal. You’ll receive the notarized PDF by email when the session ends.
Frequently asked questions
- How do I complete the confidentiality statement?
- Fill in your name and the requested dates, read the statement, then sign before a notary or Justice of the Peace. Submit the completed form as directed by the Town of Conway.
- Do I need to sign in front of a notary?
- The form includes an acknowledgment for a notary or Justice of the Peace. The signer personally appears before the officer and acknowledges executing the statement.
- Can I use a commissioned online notary?
- New Hampshire authorizes remote online notarization by its notaries under RSA 456-B:6-a. Ask the town whether it accepts a remotely notarized version; confirm with the town/city if unsure.