Georgia Notary Public Contact Information Change Form All requests are directed to the notary's commissioning county Clerk of Superior Court. Name Changes: Once you have received confirmation from the appointing Clerk of Superior Court (typically an amended notary certificate of appointment) and you have obtained a new seal bearing the new name exactly as indicated in the confirmation, you may officially begin signing your new name on notarial certificates. Most counties require personal appearance for name changes; please contact your commissioning county for specific instructions (www.gsccca.org/clerks for contact information). Address Changes: If you have moved to another county, you remain a notary of the original commissioning county until your current term expires and may continue to use your existing seal/stamp. When your term expires, you will then apply as a new notary in your new county of residence. Date: Commissioning County: Expiration Date: Notary reference number (if known): Reason for name change: (lost or stolen, marriage, divorce etc: include supporting documents) (Please Print) Name Address City State Zip Code Phone E-mail Address As Currently Commissioned Changed To ___________________________________ Notary Signature Submit to: 1. Clerk of Superior Court in the county in which you are commissioned (www.gsccca.org/clerks for contact information). AND 2. GSCCCA Notary Division 1875 Century Blvd Ste 100 Atlanta, GA 30345 Email: notary@gsccca.org Fax: (404) 327-7887 Notary Public Contact Information Change Form Ver E American LegalNet, Inc. www.FormsWorkFlow.com