Form 2301-NB227General Information (Application for Appointment as Texas Notary Public227No Bond) (FOR STATE EMPLOYEES ONLY) The attached form is designed to meet minimal statutory filing requirements pursuant to the relevant code provisions. This form and the information provided are not substitutes for the advice and services of an attorney. Commentary Notaries Public are governed primarily by Chapter 406 of the Texas Government Code, Chapter 121 of the Texas Civil Practice & Remedies Code, and the Office of the Secretary of State222s administrative rules found in Title 1, Chapter 87 of the Texas Administrative Code. Section 406.005 of the Government Code sets forth the requirements for a notary public application. Notary commissions are effective as of the date of qualification by the applicant. The commission expires four years from the date of issuance and may be renewed by filing an application for renewal no earlier than 90 days before the date the commission expires. This form is required for both new and renewed applications by employees of state agencies. Notaries employed by state agencies, as that term is defined in section 2052.101, Texas Government Code, are not required to obtain surety bonds; however, they must obtain verification of employment from the State Office of Risk Management (223SORM224) prior to submitting their applications. These notaries must also purchase an official notary seal, stating that the notary is without bond, and record book. If you cease to be employed by a state agency during the term of your notary public commission, you must either surrender your commission or obtain a bond for the remainder of the term. Instructions for Form Identifying Information: You must enter your name exactly as you intend to sign documents as a notary public. Your commission will be issued in the name on the application. The disclosure of your social security number is mandatory under Section 406.005(a), Government Code. Tex. Gov222t Code Chapter 406.It will be used only to maintain the accuracy of the Office of the Secretary of State222s records. The Office of the Secretary ofState will redact the social security number prior to providing a copy of this form in response to a public information request andwill disclose the number only when required by law.A document on file with the Office of the Secretary of State is a public record subject to public access and disclosure. When providing address information, use a business or post office box address rather than a residence if privacy concerns are an issue. The agency address provided must be a state of Texas employer222s address. Provide your email address for electronic return of your commission and you will not receive your commission by mail. Qualifying Information: By signing the application, the applicant swears to meeting the qualification requirements for the office of notary public. A notary public must be at least 18 years of age, a legal resident of Texas, and meet the criminal history requirements of 247 406.004, Texas Government Code. When reporting criminal history on this form, you must disclose findings of guilt from any jurisdiction, including state and federal courts, military tribunals, and jurisdictions outside the U.S., regardless of whether the case has been appealed. Class C misdemeanors need not be disclosed. If you are unsure of the class of a crime or whether you were found guilty, disclose the crime and explain the circumstances. Applications are subject to background investigations. If a background investigation reveals any crimes (other than a Class C misdemeanor) that you failed to disclose on your application, denial or revocation of your notary commission may result. State Office of Risk Management Verification: An authorized person for the State Office of Risk Management must verify the applicant222s state employment by signing in the space provided. Attachments: The following items must be included with the application: (1) attachments regarding criminal convictions, if any; and (2) filing fee of $11. Payment and Delivery Instructions: The filing fee for a new or renewal application for commission as a Texas notary public is $11. Fees may be paid by interagency transfer voucher (ITV) or an agency/university check. Personal checks are not accepted. Agency/university checks must be payable to the secretary of state. If payment is being remitted by ITV, a copy of the ITV, including the applicant222s name in the USAS transaction description, must be submitted with the application. A copy of the agency222s in house purchase order is not an acceptable substitute for the ITV with USAS transaction description. The completed application and filing fee must be submitted to the State Office of Risk Management, (512) 936-2927, Bonds and Insurance Section, P. O. Box 13777, Austin, Texas 78711-3777. The State Office of Risk Management will forward verified applications, along with the filing fees, to the Office of the Secretary of State. The Office of the Secretary of State will issue a notary commission upon filing of a completed, qualified application. Form 2301-NB 1 Revised 1/2018 American LegalNet, Inc. www.FormsWorkFlow.com This space reserved for office use -- APPLICATION FOR APPOINTMENT ASTEXAS NOTARY PUBLIC227NO BOND Form #2301-NB Rev. 1/2018 Submit to: STATE OFFICE OF RISK MANAGEMENT Bonds & Insurance Section P O Box 13777 Austin, TX 78711-3777 notary@sorm.texas.gov Filing Fee: $11 Identifying Information Name to be used as notary public: Last First Middle (optional) Suffix Social Security No.: Mailing Address: StreetCityTXStateZipResidence County: Agency Address: StreetCityTXStateZip Email address for return of commission (print legibly) Date of Birth://Driver222s License or Identification No.: Issuing State: Statements Relating To Qualification I, the above-named applicant, have never been convicted of a felony or crime involving moral turpitude, am at least 18 years of age and a legal resident of Texas. {All applications are subject to a background check.} A.I have been found guilty of a crime other than a Class C misdemeanor. (Applicants selecting this option must attachthe following for each crime: (1) copies of court order and sentence, and papers pertaining to release from probation;and (2) a statement of (i) the nature, circumstances, date, and location, and (ii) whether the case is on appeal.) {Aconviction for a crime involving moral turpitude OR a FELONY disqualifies you from appointment as a notarypublic under Texas law.}B.I have never been found guilty of a crime OR I have only been found guilty of a Class C misdemeanor, e.g. minortraffic violations such as speeding.State Office of Risk Management Verification THE STATE OFFICE OF RISK MANAGEMENT (223SORM224) VERIFIES THAT: The above-named applicant, an employee of , is authorized to be commissioned Agency Name Code Number as a Texas notary public pursuant to 247 653.012,Texas Government Code, without providing a notary public surety bond. Date: Signature of authorized person for SORM Printed or typed name of authorized person for SORM Statement of Officer I, the above-named applicant , do solemnly swear (or affirm) that I have not directly or indirectly paid, offered, promised to pay, contributed, or promised to contribute any money or thing of value, or promised any public office or employment for the giving or withholding of a vote at the election at which I was elected or as a reward to secure my appointment or confirmation, whichever the case may be, so help me God. Execution I declare under penalty of perjury that the facts in the foregoing Statement of Officer are true. I further certify that the information provided in and with this Application is true and correct and that I am not disqualified by law or any other reason from holding the office of notary public. Date: Signature of Applicant (sign in name given above on line #1 to be used as notary public) Form 2301-NB 2 Questions may be directed to the Notary Public Unit at 512-463-5705. American LegalNet, Inc. www.FormsWorkFlow.com