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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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OFFICE OF THE SECRETARY OF STATE
JESSE WHITE • Secretary of State
Notary Public Application Checklist
Following is a checklist for use in completing the Illinois Notary Public Application and 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.
• Illinois Notary Publics are appointed through the Secretary of State’s Index Department. Your official commission date is
assigned by this office, not the insurance company or surety bonding company that has underwritten your surety bond.
• There is a $10 filing fee for appointment and commission for each notary public. Make the check or money order
payable to the Secretary of State. Checks that have been altered, i.e. usage of correction fluid, or that are unsigned
are unacceptable. VISA, Mastercard and Discover cards also are accepted.
• 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 an officer or authorized representative.
• Each Notary Public Application must include a legible photocopy of your driver’s license or state ID card. Failure
to provide a legible copy will result in rejection of your application.
• The Name and Signature of the Applicant must read exactly the same and be notarized by another current Illinois
Notary Public including a valid rubber stamp seal. You cannot notarize your own signature.
• You must sign the bond as Principal/Applicant. This office accepts only applications and surety bonds with an original signature.
• The office of the county clerk in the county where you reside or are employed will contact you upon receipt of your
commission. Failure to register with the county will result in cancellation of your commission.
It is your responsibility to review the Illinois Notary Public Handbook. Notary public appointments are public records
and available to any interested person for examination and copying. If you have any questions or need additional assistance, please call 217-782-7017.
Springfield, Illinois 62756
♻ Printed on recycled paper. Printed by authority of the State of Illinois. February 2010 — 250 — I 160.5
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 on recycled paper. Printed by authority of the State of Illinois. February 2010 — 250 — I 160.5
American LegalNet, Inc.
www.FormsWorkFlow.com