COLORADO SECRETARY OF STATE eNOTARY CHANGE OF INFORMATION FORM Please note that this form is exclusively for changing information pertaining to a notary’s commission to notarize electronically. For name or address changes, please use the Notary Public Change Form. Name: __________________________________________ Date: __________________ Type or print the name as it appears on your current notary certificate. _______________________________________ Notary ID Number _______________________________ Commission Expiration Date Please complete the applicable section(s) below. 1. CHANGE OF EMAIL ADDRESS Old Email Address: _________________________________________ (Please type or print) New Email Address: _________________________________________ (Please type or print) 2. CHANGE OF ELECTRONIC NOTARIZATION SIGNATURE: As my new electronic notary signature, I will use (CHOOSE ONE): _____The document authentication numbers issued to me by the Secretary of State, accompanied by my name, the words “NOTARY PUBLIC” “STATE OF COLORADO” and “my commission expires” followed by the expiration date of my commission; OR _____The electronic sound, symbol, or process I have adopted as my notary signature, discrete to me and retrievable from an electronic document in perceivable form, accompanied by the document authentication numbers issued to me by the Secretary of State, my name, and the words “NOTARY PUBLIC” “STATE OF COLORADO” and “my commission expires,” followed by the expiration date of my commission. I have attached to this Notification an example of my electronic notary signature, together with a description of the technology used for its creation and the name, address, telephone number, and web or e-mail address of the supplier or vendor of that technology. 3. LOST DOCUMENT AUTHENTICATION NUMBERS OR OTHER ELECTRONIC SIGNATURE: Date of loss: _____________________________________ Number(s) lost:__________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ When completed, mail to: Colorado Secretary of State Notary Division - eNotary 1700 Broadway, Suite 300 Denver, CO 80290 or email to: enotary@sos.state.co.us American LegalNet, Inc. www.FormsWorkflow.com