STATE OF ALASKA
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NOTARY BOND FORM
Applicants may not act as their own Surety
ALL FIELDS ARE REQUIRED
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, as applicant and
___________________________________________________________________
APPLICANT NAME
_________________________________________________________________________________________________________________________________________________________________________________________
SURETY NAME
PUBLIC MAILING ADDRESS (OPEN TO PUBLIC INFORMATION)
CITY/STATE/ZIP
_________________________________________________________________________________________________________________________________________________________________________________________
PHONE
EMAIL
as surety, are held and firmly bound to the State of Alaska for the penal sum of $1000.00. We bind ourselves, our
heirs, executors and administrators for the payment of this lawful sum.
On condition of the above obligation, the Honorable Lieutenant Governor of Alaska has appointed and
commissioned this applicant, a Notary Public in and for the State of Alaska, for a term of 4 years from the issuance
of the commission.
If the above named applicant performs their duties as Notary Public as prescribed by law, then the obligation of the
bond is null and void. However, if the above named applicant fails to perform their duties as Notary Public as
prescribed by law, then the obligation of this bond is in full force and effect.
Surety must inform the Lieutenant Governor of any change in financial status which would void the above
statement.
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NOTARIZED SIGNATURE OF SURETY
FOR NOTARY PUBLIC USE ONLY
Subscribed and sworn to before me in _________________, by ________________________________________,
CITY
PRINT NAME OF SURETY
this _________ day of ____________, 20___________
_________________________________________
NOTARY PUBLIC SIGNATURE
_________________________________________
COMMISSION EXPIRATION DATE
Mail this ORIGINAL form in with the Application
FOR FURTHER INFORMATION CONTACT: THE NOTARY ADMINISTRATOR,
240 MAIN STREET, ROOM 301, JUNEAU, AK 99801
(907) 465-3509, EMAIL:
notary@alaska.gov