STATE OF IDAHONOTARY PUBLIC COMMISSIONNAME OR ADDRESS CHANGE611 This block for Secretary of State use only. Notary Signature:Rev. 07/2017 NAME CHANGE: Enter your name exactly as it will appear on your new notary seal. First Name:Middle Name or Initial (if used):Last Name: Physical Address (not a PO Box):City:State:Zipcode: CHANGE PHYSICAL ADDRESS: Enter your new physical address. City:State:Zipcode: CHANGE MAILING ADDRESS: Enter your new Fees: Name or Physical Address Change 226 $5.00 Mailing Address Change Only 226 No ChargeSubmit this form with payment to:Idaho Secretary of StatePO Box 83720 SELECT CHANGE(S):Name Change Change Physical Address Change Mailing Address Agency phone: Yes No government employee? Government employment: Commission Number: First Name:Middle Name or Initial (if used):Last Name: CURRENT COMMISSION NAME : American LegalNet, Inc. www.FormsWorkFlow.com