"I declare under penalty of perjury under the law of Georgia that the foregoing is true and correct, and that I am physically located outside the geographic boundaries of the United States, Puerto Rico, the United States Virgin Islands, and any territory or insular possession subject to the jurisdiction of the United States.
Signed on the Date__________ day of Month________, Year______ at _______________City or other location, and state or country__________________.
Printed name__________________
Signature."__________________
OCGA § 9-1-1