Application For Appointment As An Alabama Notary
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1APPLICATION FOR APPOINTMENT AS
Office of the Secretary of State
AN ALABAMA CIVIL-LAW NOTARY
Alabama Civil-law Notaries
Form ACLN-1
Effective xxxxxx xx, xxxx
Full Name:
(Last)
(First)
(Middle)
Date of Birth: ______/______/_________
Alabama Bar ID Number:
Place of Employment:
Business Address:
(Street)
(City)
(State)
(Zip Code)
Residence Address:
(Street)
(City)
(State)
(Zip Code)
Home Phone: (
)
Business Phone: (
)
FAX Number: (
)
E-mail Address:
Please attach to this application:
1) A certificate of good standing from the Supreme Court of Alabama issued within 90 days of this
application, showing that you are currently a member of the Alabama Bar and have been a member of
the Alabama Bar for at least 5 years;
2) An application processing fee in the amount of $100.00.
CERTIFICATION
I hereby certify that the information indicated on this application is true and accurate and that I understand
any false statements herein constitute a violation of §13A-10-102, Code of Alabama (1975). I further certify
that I am eligible to be appointed an Alabama Civil-law Notary, and that my name appears on this application
as an Alabama Civil-law Notary.
(Print or Type Legal Signature of Applicant)
(Legal Signature of Appointee as it will appear on notarial acts)
(Date)
l
l
Office of Secretary of State
P.O. Box 5616
Montgomery, Alabama 36103-5616
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