STATE OF IDAHO
APPLICATION FOR APPOINTMENT AS NOTARY PUBLIC
PLEASE READ CAREFULLY AND COMPLETE ALL ITEMS.
FAILURE TO COMPLETE THE ENTIRE FORM WILL CAUSE REJECTION OF YOUR APPLICATION.
Mail to: Secretary of State, Notary, P.O. Box 83720, Boise, Idaho 83720-0080.
I, _________________________________ , hereby apply for appointment to a commission as
Notary Public for the State of Idaho. I make the following statements in support of the application:
(1) I am on this date at least eighteen (18) years of age.
(2) My gender is Male
(check appropriate box).
(3) Former Name (if you have previously been commissioned in Idaho under another name): ________________________________
(4) Have you previously been commissioned in Idaho?: No
(5) I reside at: _______________________________________________________________________________________________
(6) If I am not a resident of Idaho, I am employed or doing business in Idaho at ___________________________________________
(Name of business)
(7) The mailing address to which the certificate should be sent (if different from (5)) is ____________________________________
(Street Address or P. O. Box)
(8) Name, address and phone number of insurance agency which wrote the notary bond: __________________________________
Name of Agency)
(9) Name of bonding company and bond number: _________________________________________________________________
10) I am able to read and write the English language.
(11) I have not been convicted of a serious crime nor removed from the office of Notary Public for official misconduct within the past
ten (10) years.
NOTE: If the applicant cannot truthfully make the statements in Items (1), (6), (10), and (11) above, he or she is ineligible to hold the
office of Notary Public, and should proceed no further with this application.
APPLICANT: Affix specimen of your (rubber stamp) seal here
(Seal can be purchased from office supply, stationery or stamp company)
OATH OF OFFICE
I ________________________________________ , solemnly swear (or affirm) that the answers to all questions in this
application are true, complete and correct; that I have carefully read the notary laws of this State and I am familiar with their provi-
sions; that I will uphold the Constitution of the United States and the Constitution and laws of the State of Idaho; and I will faithfully
perform, to the best of my ability, the duties of the office of Notary Public.
State of Idaho
County of ________________)
Subscribed and sworn (or affirmed) before me
this _____ day of _________________ , 19_____.
Notary Public signature
My commission expires on_____________, 19____.
DETACH AND RETURN THIS FORM ALONG WITH
THE $30.00 FILING FEE AND ORIGINAL NOTARY BOND.