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Notary Public Application Checklist And Credit Card Transaction Form. This is a Illinois form and can be use in Notary Public Secretary Of State.
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Tags: Notary Public Application Checklist And Credit Card Transaction Form, I-160.4, Illinois Secretary Of State, Notary Public
OFFICE OF THE SECRETARY OF STATE
JESSE WHITE • Secretary of State
Notary Public Application Checklist
Dear Notary Applicant:
The following checklist should assist you when completing the Illinois Notary Public Application and surety bond:
•
There is a $10 filing fee for appointment and commission for each notary public. The check or money order
should be made payable to the Secretary of State. Checks which have been altered, i.e. usage of correction fluid,
or are unsigned are unacceptable. This office also accepts VISA, Mastercard and Discover cards (see reverse
side).
•
Each Notary Public application must include a $5,000 Illinois Notary Public Bond issued by a company
qualified to write surety bonds in Illinois. This office does not accept the Public Official Bond or Errors and
Omissions Policy. The surety bonding company's corporate seal must accompany the Signature of
Officer or Authorized Representative.
•
The Illinois Notary Public is appointed through the Office of the Secretary of State's Index Department. Your
official commission date is assigned by this office, not the insurance company or surety bonding company who
has underwritten your surety bond.
•
To become an Illinois Notary Public, you must be an Illinois resident or a resident of a qualifying bordering
state. Illinois Residents are commissioned in the county in which they reside. Out of State Residents are
commissioned in the county in which they are employed.
•
Your name and Signature of Applicant must read exactly the same and be notarized by another current Illinois
Notary Public; their valid rubber stamp seal must be affixed. You cannot notarize your own signature.
•
On the bond side, you must sign as Signature of Principal/Applicant. This office accepts only applications and
surety bonds with an original signature.
•
The office of the county clerk, in the county in which you reside or are employed, will contact you upon their
receipt of your commission. Failure to register with the county will result in cancellation of your commission
Please take the time to review the Illinois Notary Public Handbook, in particular pages 4 and 15 which describe a
valid Illinois rubber stamp seal, and page 5 which concerns your signature. Notary public applications and
appointments are public records and are available to any interested person for examination and copying. If you have
any questions or need additional assistance, please contact (217) 782-7017.
Springfield, Illinois 62756
Printed by authority of the State of Illinois. October 2006 — 1 — I 160.4
American LegalNet, Inc.
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Secretary of State Index Department
Notary Public - Credit Card Transaction Form
Notary applicant name and home residence:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Check one
❐
VISA
❐
Discover
❐
MasterCard
Credit Card number and expiration date:
Card # ________________________________________ Exp. date __________________
Name of authorized representative of credit card and address:
_________________________________________________________________________
_________________________________________________________________________
Telephone number: _____________________________________________
Authorized signature of representative of credit card: (Must be included in order to process)
________________________________________________________________________
NOTE:
A FEE OF $2.00 WILL BE CHARGED FOR EACH TRANSACTION BY THE CREDIT
CARD COMPANY FOR THIS SERVICE.
Printed by authority of the State of Illinois. October 2006 — 1 — I 160.4
American LegalNet, Inc.
www.FormsWorkflow.com