Rli Insurance Company Notary Bond | Az Notary Bond Insurance

Notary Public Application

By submitting this application you hereby certify under penalty of perjury that all information contained herein is true and correct, and that you are 18 years of age or older. Once approved and elected, you must then be commissioned by the Governor. In addition, you will be required to post a bond in the amount of $10,000. This bond must be filed in the office of the County Clerk where you will pay the required fees and take the oath of office. You are not an authorized notary public until you have received your commission from the Governor, filed your bond, and taken the oath of office. You must be a United States Citizen or a legal permanent resident of the United States. Should you move your residence or your principal place of business out of this county, you are required to notify the County Clerk of the change of address, and you must pay a fee of $2.00.
Please Answer ALL of the Following Questions
Date of Application:
11/14/2018
First Name
Middle Name (optional)
Last Name
Suffix (optional)
Notary Name
Notary First
Notary Middle (optional)
Notary Last
Notary Suffix (optional)
  Applicant's Printed Name Exactly As You Wish To Appear On Notary Commission
Home Address
Street
City
State
Zip
Business Address
Employed By
Business Address Same As Home Address
Business Street
Business City
Business State
Business Zip
Corporate Bond (optional)
Individual Bond 1 (optional)
Individual Bond 2 (optional)
Home Phone:
- -
Business Phone (optional)
- -
Date of Birth
Email Address
Confirm Email Address
Answering Yes to any of the following questions will disqualify this Notary Application
1. Have you ever been convicted of offering and/or giving a bribe, larceny, or any other offense declared infamous by law? 2. If you answered question 1 with YES, has your citizenship been restored? 3. Is there an unpaid judgment against you for moneys received in an official capacity, due to the United States, to Tennessee, or to any of its counties? 4. Are you a defaulter to the treasury? 5. Are you serving as a soldier, sailor, marine, or airman in the Army, Navy, or Air Force of the United States? 6. Are you a member of Congress, or a person holding any office of profit or trust under any foreign power, other state of the union, or under the United States? 7. Have you ever been removed from office of Notary Public for official misconduct? 8. Have you ever had a notarial commission revoked by Tennessee or any other state? 9. Have you ever been found by a court of Tennessee, or of any other state, to have engaged in the unauthorized practice of law? 10. Is there any other reason that you are legally disqualified from holding the office of a Notary Public?
Were ANY of the previous questions Yes?  
Legal Binding Disclaimer:
This Notary Application is a legal binding document between you and Greene County.
Commission only - No Stamp $14.00
Payment Information:
Application Fee
$
Convenience Fee
$ 1.00
Credit Card Fee (2.25%)
$ 0.00
Total
$
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