Know all people by these presents that We, <King/Prince> and <Queen/Princess>, (King and Queen of Atenveldt/Prince and Princess of Artemisia), in recognition that Our subject <name> has once reigned as Princess in Our realm, do hereby acknowledge her as Viscountess and Lady of the Papillon. We hereby affirm her right to bear the following arms by letters patent in the Society for Creative Anachronism: <blazon>. In witness whereof We set Our hands and seals this ___ day of ___, Anno Societatis ___, being the year two thousand in the Common Era at <event> in Our <S.C.A. group>.
(Rex Atenveldtus/Princeps Artemisia) (Regina/Princepessa)
[Source: Kingdom of Artemisia Scribal Handbook Part II (pdf)]