Instructions to fill out Form: 1. You may either print the blank form out and complete and mail back to this office. 2. Place mouse cursor on the line in the first box. 3. To see a highlighted view of where the fields are, in the upper right hand corner of Adobe Reader, there is “Highlight Fields” button click this button. 4. Formats have been provided in the date and number boxes. 5. Hit the tab or enter button to move from box to box. Not all text boxes are visible but are provided. 6. Where necessary, you have the option of hitting return for multiple lines. (i.e. addresses) 7. Once you have completed the form, print and mail to: Office of the Secretary of State, State House, Annapolis, MD 21401 8. When form is completed, click the “Print Form” button next to the “Highlight Fields” button or use the Print button from your menu bar. American LegalNet, Inc. www.FormsWorkFlow.com NOTARY DIVISION OFFICE OF THE SECRETARY OF STATE, STATE HOUSE, ANNAPOLIS, MARYLAND 21401 (410) 974-5520 Please complete and return to the above address this application to renew your notary commission and a non-refundable $20.00 check or money order made payable to the Secretary of State. Please note that applications not accompanied by the $20.00 processing fee will not be processed. There is a $25.00 fee for all returned checks. Renewal application must be received no later than 30 days past expiration date, or applicant must apply as a new notary. Legal Name: Date of Birth: male female Home Address: County: City, State, Zip: Home Phone: Business Phone: Please check here if your name, home address, or telephone numbers have changed since you submitted your last notary application. If this information has changed, please provide your former name, address, County or telephone numbers. Legal Name as it appears on commission: Former Home Address: Former County: City, State, Zip: Home Phone: Business Phone: NON-RESIDENTS ONLY: I request to be commissioned in ________________County or ___ Baltimore City. Have you ever been convicted of a crime, other than a minor traffic violation? If yes, please describe the nature of the conviction and date of conviction. Yes No Have you ever held a commission as a Notary Public in any state which was revoked? If yes, please explain: Yes No We occasionally share our mailing list with businesses. Please check the box to the left if you do not want your name included on such a list. I wish to renew my notary commission and have enclosed the $20.00 processing fee. SIGNATURE: I SOLEMNLY AFFIRM under penalties of perjury and upon personal knowledge that the contents of the foregoing paper are true. ____________________________________________________________ Signature must match the name provided above You will receive a postcard notifying you to pick up your renewal commission from the Clerk of the Circuit Court in the county in which you reside (Maryland residents) or in the county in which you have selected (nonMaryland residents). When you receive this postcard, you must appear before the Clerk of the Circuit Court within 30 days to be sworn in for your new term and pay the Clerk a commissioning fee of $11.00. Failure to be sworn in within 30 days will result in the revocation of the appointment and commission. If you have not received a postcard within 10 days of submitting this form, please contact the appropriate Clerk of the Circuit Court to verify that your commission has been received. PLEASE APPLY YOUR NOTARY SEAL TO THE BACK OF THIS PAGE American LegalNet, Inc. www.FormsWorkFlow.com Local Elections Offices Allegany County Anne Arundel County Baltimore City Baltimore County Calvert County Caroline County Carroll County Cecil County Charles County Dorchester County Frederick County Garrett County Harford County Howard County Kent County Montgomery County Prince George’s County Queen Anne’s County St. Mary’s County Somerset County Talbot County Washington County Wicomico County Worcester County 301-777-5932 410-222-6600 410-396-5550 410-887-5700 410-535-2214 410-479-8145 410-386-2080 410-996-5311 301-934-8972 410-228-2560 301-600-8683 301-334-1962 410-638-3564 410-313-5820 301-778-0038 240-777-8500 301-430-8020 410-758-0832 301-475-4655 410-651-0767 410-770-8099 240-313-2050 410-632-5500 410-632-1320 American LegalNet, Inc. www.FormsWorkFlow.com