Montana Secretary of State Certifications and Notary ServicesPO Box 202801 Helena, MT 59620-2801 Indicate the item(s) to be changed: Name Home Mailing Address Physical/Residential Address Type or print the following information as it appears on your current Certificate of Commission: Name Commission Expiration Date City of Residence New Name New Name (Type or Print) - Name must match name on rider Notary name changes must be accompanied by a "name change rider" issued by your insurance company or bonding agency. An amended Certificate of Commission reflecting your name change will be e-mailed to you. New Home Mailing Address Home Mailing Address State Zip Code City Zip Code State Physical/Residential Address New Physical/Residential Address City New Employment Information Name of Employer/Business If your city has changed, an amended Certificate of Commission will be e-mailed to you. Employer/Business Telephone Number (include area code) Zip Code State City Employer/Business Address New Home/Cell Telephone Number Home/Cell Telephone Number (include area code) New Personal E-mail Address Personal E-mail Address Change in Use of Electronic Notarization Technology I will no longer be performing notarial acts with respect to electronic records. I will be performing notarial acts with respect to electronic records. The tamper proof technology I will be using is: Signature DateMail completed and signed form to address above.Montana Notary Public Information Update Contact us: (406) 444-1877 sosnotary@mt.gov www.sos.mt.gov/notary Employment Information Use of Electronic Notarization Technology Opt-out of "City Search" list for http://NotarySearch.mt.gov Home/Cell Telephone Number Personal E-mail AddressRev. 10/15 Type or print your personal e-mail address: American LegalNet, Inc. www.FormsWorkFlow.com