Fillable Application For Notary Public Commission Renewal Form printable pdf download

Application For Notary Public Commission Renewal Form

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APPLICATION FOR NOTARY PUBLIC COMMISSION RENEWAL

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I. APPLICANT INFORMATION

Name

Address

Phone

DOB

Sex

First/Middle/Last

II. AFFIDAVIT

Georgia, ______________________________ County

To the Honorable __________________________________________, Clerk of ______________________________ Superior Court:

I, the undersigned, in making this application for a Notary Public Commission, do hereby state that:

I am a legal resident in this county and reside at the address shown above OR I am a resident of a state bordering on the State of Georgia

and carry on a business or profession in the State of Georgia in this county or am regularly employed in the State of Georgia in this county

at the address shown above;

I am at least eighteen years old, and my age and sex are shown above;

I am a United States citizen or I am a legal resident of the United States;

I have an operating phone, the number is listed above; and

I can read and write the English language.

I, the undersigned applicant, further state that I submit this application to be appointed a notary public pursuant to the provisions of Title 45, Chapter

17, Article 1, as amended, of the Official Code of Georgia Annotated. I list below all denials, revocations, suspensions, restrictions, or resignations of

any notary commission held by me and list below all my criminal conviction(s), including any plea(s) of nolo contendre, except minor traffic

violations:

III. DECLARATION OF APPLICANT AND NOTARY PUBLIC

I, the undersigned applicant, do solemnly swear/affirm under penalty of perjury that the personal information I have written in this application is true,

complete and correct.

____________________________________________________________

Signature of Applicant

Georgia, ______________________________ County

On the date and time written herein, the person who signed the preceding declaration appeared before me and, in my presence, swore/affirmed that

he/she understood the document and freely declared it to be truthful.

Official Seal of Notary

____________________________________________________________

Official Signature of Notary

III. DECLARATION OF APPLICANT AND NOTARY PUBLIC

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