Application For Notary Public - Tennessee Secretary Of State

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County Clerk Use Only
Hamilton County, Tennessee
Date ______________
1. Send $12.00 with this notarized application. Make checks payable to “Hamilton County Clerk.”
2. A notary desiring to make application for reappointment should apply to the County Clerk’s Office eight weeks prior to the expiration
of the previous commission.
3. After completing this application and returning it to the County Clerk’s Office (625 Georgia Avenue, Room 201, Chattanooga, TN
37402), the County Commission will consider the application at its next scheduled bi-monthly meeting.
4. Upon notification by the County Clerk’s Office that you have been approved as Notary Public for the State of TN, you must next
secure a $10,000 notary public surety bond payable to the State of TN. The term of the bond shall be four years beginning on the
date of the issuance of the commission by the Governor. After securing the bond, you must appear with said bond in Room 201 of
the Hamilton County Courthouse. A recording fee of $2.00 will be assessed at that time. For additional information call 209-6500.
NOTE: You must notify County Clerk if you move residence or business to another TN County. (Form 205a—“Change of Address”).
Check One:
PLEASE PRINT: Full Name _______________________________________________________________________________
Notary Name ___________________________________________________________ ______________________________
Print Name that you will use when notarizing documents. (Must match signature below.)
Social Security Number
__________________________________________________ ______________________________ _______ ____________
Residence Address
Residence Phone
Birth Date
_________________________________________________________________ ____________________________________
Name of Employer
Business Phone
_____________________________________________________ _________________________ __________ ___________
Business Address
If presently commissioned as a Notary Public, give expiration date of most current commission ________ / _______ / ________
To qualify for a public office a person must be at least eighteen (18) years of age and be in compliance with Tennessee Code Annotated (TCA 8-18-101). All
notaries must be a resident of the county, or have their principal place of business in the county from which they were elected. If an individual has his principal
place of business in any county in the state of Tennessee, he shall be eligible for election as a notary at large, although he may reside in a state other than
Tennessee (TCA 8-16-101). All notaries must be a U.S. citizen (Publiic Chapter No. 834, Acts 2008).
All individuals meeting these qualifications are eligible for election as a notary public at large except the following persons:
(1) Those who have been convicted of offering or giving a bribe, or of larceny, or any other offense declared infamous by law, unless restored to citizenship in
the mode pointed out by law;
(2) Those against whom there is a judgment unpaid for any moneys received by them, in any official capacity, due to the United States, to this state, or any
county of this state;
(3) Those who are defaulters to the treasury at the time of the election, and the election of any such person shall be void;
(4) Soldiers, sailors, marines, or airmen in the regular army or navy or air force of the United States; and
(5) Members of congress, and persons holding any office of profit or trust under any foreign power, other state of the union, or under the United States. (8-18-101).
(6) Those who have been removed from the Office of Notary Public for official misconduct.
(7) Those who have had a notarial commission revoked by this or any other State.
(8) Those who have been found by a court to have engaged in the unauthorized practice of law.
I certify that this application has been completed and examined by me and to the best of my knowledge and belief is a true and complete application made in
good faith pursuant to the provisions of Chapters 16 and 18, Title 8, of the Tennessee Code Annotated, dealing with Notaries Public.
Please photocopy this form for your
_______________________________ _______________
records before submitting to County Clerk.
Applicant’s Signature
(Must match “Notary Name” above)
Applicants Signature Must Be Notarized.
Sworn to and subscribed before me this ___________________
day of ____________________________, ________________
Signature of Notary Public and Seal
My commission expires _________________ ______________
Application for Notary Public/BK-
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