Revised /201 Maryland NOTARY PUBLIC APPLICATION OFFICE OF THE SECRETARY OF STATE STATE HOUSE, ANNAPOLIS, MARYLAND 21401 Email: dlnotarysos@maryland.gov or call () PLEASE READ APPLICATION CAREFULLY AND PRINT CLEARLY. To apply for your Maryland Notary Public Commission you must do the following: 1. Complete and submit this application to the above address along with a copy of your DLicense or MVA State Identification Card that has your current address. 2. If the address on your ID does not match your application, please provide a change of address card from the MVA that shows the address on your application as your actual home address. 3. Submit a non-refundable $9.00 fee by check or money order made payable to the Secretary of State. A $25.00 fee will be charged for all returned checks. 4. If you have any questions, email us at dlnotarysos@maryland.gov or call (410) 974-552. 5. If your application is approved, you will receive an email explaining what to do next. Check your Spam folder, not just your Inbox for that email. 6. The Clerk of the Court charges an additional fee of $11.00 when you are sworn in. Check with the Clerk of the Court for accepted payment methods. Maryland Residents: Call the Elections Office in the county in which you reside or City of Baltimore or visit the website: www.mdelect.net to find the information requested below, and complete the following: I am a resident of the Legislative District, County or Baltimore City, represented by State Senator . Non-Residents: I request to be commissioned in County or Baltimore City. You will be notified of the decision about your application by email. Please check the box to the left if you do not want your name and email shared with businesses. PLEASE PRINT ALL INFORMATION: Legal name as it should appear on your commission Date of Birth : Permanent Home Address, City, State, Zip Social Security # (Required) Home /Cell Phone: Email ( Required ) : Name of employer /Self - employed Occupation Work Address, City, State, Zip Work Phone Have you ever had a Notary Public C omm ission revoked in any state? Yes No Have you ever been convicted of a crime other than a minor traffic violation ? Yes No Have you ever had any civil judg me nts in the last 7 years , satisfied or not ? Yes No A thorough background check is conducted . If yes to any or all questions , please explain the nature of crime and/or civil judgme nt and the date of occurrence , on a separate sheet of paper , and atta ch to this application. RENEWALS ONLY : If you have changed your name, indicate prior name If your address has changed, indicate new county if this applies: TYPE OF APPLICATION: NEW RENEWAL If renewing, place notary seal next to State Senator box. American LegalNet, Inc. www.FormsWorkFlow.com References: List 3 references (not family members or your employer) who may be contacted to attest to your character (Optional for renewals); Email addresses are required please print clearly. Name: Email ( Required ) : Street Address: Phone: Male Femal e City: State: Zip: Name: Email ( Required ) : Street Address: Phone: City: State: Zip: Name: Email ( Required ) : Street Address: Phone: City : State: Zip: PLEASE READ AND INITIAL EACH STATEMENT. A Maryland Notary Public must The Handbook for Maryland Notaries Public in its entirety. The handbook is located at the following website: http://sos.maryland.gov A notary must always be completely satisfied with the identity of the person whose signature is being notarized. claims to be. Always check identification and be satisfied that the ID is valid. A notary is not authorized to perform marriages, certify birth, marriage/death certificates or any act that constitutes the practice of law. A notary is not an attorney and cannot practice as one. A notary must notify this office of any changes to the information provided on this application in writing. A notary must always keep a fair registry book no matter how many or few notaries they perform. A notary must contact the notary division if you are performing e-notarizations. Additional information must be provided. Call or email office at 410-974-5520 or dlnotarysos@maryland.gov . Do you read and write English? Yes No . If no, please specify your primary language Are you a registered voter in Maryland? Yes No. If no, what state? The maximum fee by law a notary can charge is $4.00 per notarial act. You will receive a postcard and/or email notifying you to pick up your commission at the Circuit Court in the county in which you reside. When you receive the notification, you must appear before the Clerk of the Circuit Court within 30 days to be sworn in for your new term. Failure to be sworn in within 30 days will result in the revocation of the appointment and commission. You will pay the Clerk an additional commissioning fee of $11.00 I SOLEMNLY AFFIRM under penalties of perjury and upon personal knowledge that the contents of this applicatio n are true. Signature Date ATTACH A COPY OF YOUR OR MVA STATE IDENTIFICATION CARD AND THE $9.00 FEE WITH THE APPLICATION State Senator Use Only References contacted? Y N Verified employment? Y N Background checked? Y N APPROVED DENIED State Senator Legislative District Date For renewals, place seal here American LegalNet, Inc. www.FormsWorkFlow.com