Form Sos/np 34 - Notary Public Address Change - California Secretary Of State Page 2

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STATE OF CALIFORNIA
SECRETARY OF STATE
NOTARY PUBLIC ADDRESS CHANGE
IMPORTANT-TYPE OR PRINT IN INK
Read instructions on back before completing this application.
This application is presented for filing pursuant to Government Code Section 8213.5
1. PRINT NAME EXACTLY AS SHOWN ON COMMISSION:
(FIRST)
(MIDDLE)
(LAST)
2. COMMISSION NUMBER
3. EXPIRATION DATE
4. NAME OF PRINCIPAL PLACE OF BUSINESS
5. BUSINESS ADDRESS (DO NOT LIST A P. O. BOX)
CITY
ZIP CODE
,CA
6. ADDRESS WHERE YOU RECEIVE YOUR BUSINESS MAIL (IF DIFFERENT
CITY
ZIP CODE
FROM 5.)
,CA
7. ADDRESS WHERE YOU LIVE (NUMBER, STREET, APARTMENT NO.
CITY
ZIP CODE
DO NOT LIST A P. O. BOX)
,CA
8. E-MAIL ADDRESS (OPTIONAL)
9. ______________________________________________________________________________________________________________________________
SIGNATURE
DATE
SOS/NP 34 (7/03)

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