Submit this form No fee STATE OF OREGON Corporation Division – Notary 255 Capitol Street NE, Suite 151 Salem, OR 97310-1327 503-986-2593 FAX 503-986-2300 FilingInOregon.com/notary This Space For Office Use Only NOTARY PUBLIC WAIVER OF FEES COMPLETE ALL SECTIONS. PLEASE TYPE OR PRINT LEGIBLY IN BLACK OR DARK BLUE INK. Notary Commission No: Commission Expiration: Notary Commission Name: Mailing Address where notary materials should be mailed Daytime Phone Number & Extension: (Include city, state, zip) ( ) I wish to rescind the waiver of fees and begin charging for my services. I wish to waive the right to charge fees for my notarial duties. Before sending this form in, please check your records to see whether you actually signed the fee waiver when you originally applied. We do not send acknowledgment letters. Signature as it appears on Commission Effective date of change 517 (Rev. 4/08) American LegalNet, Inc. www.FormsWorkflow.com