Company XYZ Sample Corporate Notary Sign-Up Form

Sample Corporate Signup Form

Product Name
Welcome XYZ Employees. Please tell us whether you are Becoming a Notary Public or Renewing an Existing Commission?
- I am a new Notary Public
- I am Renewing my Existing Commission
Please Enter Your Requested Notary Commission START DATE*
Month
Day
Year

NOTE: Choose any date within 30 days of today's date.
Please Enter Your Existing Notary Commission EXPIRATION DATE
Month
Day
Year
Please tell us your Employee Number (For Billing Purposes)*
Please Tell Us The Cost Center (For Billing Purposes)*
Notary Public Name (exactly as you sign it)*

IMPORTANT: If you sign with a middle Initial, make sure you only include your middle initial here. The same can be said if you sign just your first and last name, only use your first and last name here.
Name of County of your RESIDENCE*
Please Enter Your Home Mailing Address*
Street Address City State ZIP Code

Your Notary Public Commission is Based On your Residence Location and County.
Please Enter Your Best Contact Phone Number*
Please Provide a Valid Email Address
Enter Email Confirm Email
Would You Like To Add a Journal Of Notarial Acts?*
This Hard Back Notary Journal has space for 400 Notary entries. This is an Official Records Journal for Notary Publics and is required by the Arizona Secretary of State
What Color Ink Would You Like For Your Self-Inking Stamp?*
Would You Like To Add an Inkless Thumb Printing Pad?
For your ultimate protection against fraudulent claims, aquiring a thumb print in your Journal of Notarial Acts can help you overcome potential risks or losses.
Application Questions
Have you ever been convicted of a felony OR a lesser offense involving moral turpitude of a nature that is comparative with the duties of a notary public?*
If “YES” have you had you civil rights restored? If your rights have been restored you MUST provide and attach: court documentation that demonstrates the restoration of your civil rights; and a court or law enforcement issued document that refers to the nature of the original charges.
Have you ever had a professional license revoked, suspended, restricted, or denied for misconduct, dishonesty, or any cause that substantially relates to the duties or responsibilities of a notary public? If yes, please explain below.*
Please tell us what happened?
Have you ever had a notary commission revoked, suspended, restricted, or denied in this state or any other jurisdiction? If yes, attach an explanation statement.*
Please tell us what happend to your previous Notary Commission?
Are you 18 years of age or older?*
Are you a citizen or a legal permanent resident of the United States? ***
Do you claim Arizona as your primary residence for state and federal tax purposes?*
Have you been commissioned as a notary public in any other state or jurisdiction?*
What other Jurisdiction(s) have you been Commissioned in?
Will you be performing notarizations in languages other than English? Note: You must be able to understand a language in order to perform notarizations in that language. Information provided is a public record.*
What other languages will you be performing Notarizations in?
Personal Information (Required for Application)
Your Social Security Number*
Your Drivers License / State Identification Number*
Drivers License / State ID Issue Date?*
Month
Day
Year
Drivers License / State ID Expiration Date (If Any)*
Month
Day
Year
Your Date Of Birth*
Month
Day
Year
Your Gender*
Shipping Fee for Supplies

If you choose to purchase supplies, a $8.50 fee will be added to your total to ship the items.
Total
$0.00

Company XYZ Sample Corporate Notary Sign-Up Form

Sample Corporate Signup Form

Application Questions

Personal Information (Required for Application)

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