Form Ssn-514 - Application For Appointment & Reappointment For Notary State At Large March 2008 Page 2

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NOTARY APPLICATION FOR NEW APPOINTMENT & REAPPOINTMENTS
INSTRUCTIONS BY LINE
Line 1
List your name as it is to appear on the Certificate of Appointment
Line 2
List your date of birth
Line 3
List daytime phone number
Line 4
List your home address where your written notice of appointment will be mailed
Line 5
List County of application - If a Kentucky resident, the county of application is the county where the
applicant resides OR is principally employed. For an applicant who is not a Kentucky resident, but is
employed in Kentucky, the county of application is the county in which he or she is principally employed.
(The county on this line should match the county of the official signature at the bottom on the certificate of
approval.)
Line 6
Check new appointment or reappointment – if reappointment, list expiration date. If previously a notary
public and your commission has expired, please check new appointment. Please do not send reappointments
in earlier than four (4) weeks before your current notary will expire.
Line 7
Requirements for becoming a notary
Line 8
Signature of applicant as printed on Line 1
*You must complete the Certificate of Approval by an Official BEFORE mailing to Notary Commissions
Mail completed application along with the fee of $10.00 (payable to the Kentucky State Treasurer) to:
Notary Commissions
PO Box 821
Frankfort, KY 40602-0821
After the application has been processed by the Secretary of State, your Certificate of Appointment will be sent to the county
clerk in the county of application. For a Kentucky resident, the county of application is the county where the applicant resides
or is principally employed as designated in line 5. For an applicant who is not a resident of Kentucky, but is employed in
Kentucky, the county of application is the county in which the non-resident is principally employed. At the same time the
Secretary of State sends the Certificate of Appointment to the county clerk, a written notice will be sent to the applicant stating
the Certificate of Appointment can be obtained from the county clerk’s office. Within thirty (30) days of receiving your
notice, you must go to the county clerk’s office and
(1)
Post Bond;
(2)
Take the Oath of Office;
(3)
File and record your commission in the office of the county clerk.
For specific information regarding the bonding and oath process, you should make direct contact with your county clerk.
Failure to post bond and take the oath will cause your commission to become void. This will necessitate the submission of a
new application and fee to become a commissioned notary.
Revised 03/08
SSN-514

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