Application For Notary Commission
Application For Notary Commission
I. Applicant Information
Full Legal Name: [Your Name]
Residential Address: [Your Company Address]
City, State, Zip Code: [City], [State], [Zip Code]
Email: [Your Company Email]
Phone Number: [Your Company Number]
II. Employer Information (if applicable)
Company Name: [Company Name]
Company Address: [Company Address]
City, State, Zip Code: [City], [State], [Zip Code]
Company Phone Number: [Company Phone Number]
III. Notary Public Information
Name for Commission: [Your Name's Commission]
Commission Number (if applicable): [Your Commission Number]
Commission Expiration Date: [Your Commission Expiration Date]
Date of Appointment: [Date of Appointment]
Bond Amount: [Bond Amount]
IV. Professional References
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Reference Name 1: [Reference Name 1]
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Contact Information: [Contact Information]
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Reference Name 2: [Reference Name 2]
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Contact Information: [Contact Information]
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Reference Name 3: [Reference Name 3]
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Contact Information: [Contact Information]
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V. Oath of Office
"I, [Your Name], do solemnly swear (or affirm) that I will support, protect, and defend the constitution and government of the United States and of the state of [Your State], that I am duly qualified to hold office under the constitution and that I will well and faithfully perform the duties of Notary Public of the state of [Your State] on which I am now about to enter."
Date: [Current Date]
VI. Affirmation
"I, [Your Name], understand that providing false information on this application may result in criminal conviction and revocation of my notary public commission.”
Date: [Current Date]
VII. Submission
Please submit this application alongside a copy of valid identification to the [Your State’s Notary Commission Office Address]
[City, State, Zip Code]
