Form 2305-NB--General Information (Application for Change of Name as Texas Notary Public Without Bond) 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 The name change procedure is optional. A notary public may continue to sign the name on his or her commission until the commission expires and change the name upon commission renewal. State employees appointed as Texas notaries without bond must use this form to apply for a name change. The name change will be effective on the date all four items listed below are received in this office providing there are no errors or omissions. An amended commission reflecting the name change and the effective date of the change will be issued. Instructions for Form A document on file with 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. Social Security Number: The disclosure of your social security number is mandatory. It is solicited by the authority of Chapter 406, Government Code and will be used only to maintain the accuracy of the secretary of state's notary public records. The secretary of state will redact the social security number prior to providing a copy of this form in response to a public information request. Attachments: The following items must be included with the application for name change: 1. Certificate of commission. Return your original notary public commission with the application. The secretary of state will destroy the original commission upon issuance of an amended commission reflecting the name change. If you no longer have your commission, submit a statement that you will perform all future notarial acts under the name specified on the amended commission. 2. Filing fee of $10. Payment and Delivery Instructions: The filing fee for an application for change of name as a Texas notary public is $10. Fees may be paid by personal checks, money orders, interagency transfer of funds, LegalEase debit cards or MasterCard, Visa, and Discover credit cards. Checks or money orders must be payable through a U.S. bank or financial institution and made payable to the secretary of state. Fees paid by credit card are subject to a statutorily authorized convenience fee of 2.7 percent of the total fees. If payment is being remitted by an interagency transfer of funds, a copy of the interagency transaction voucher (ITV), including the applicant's name in the USAS transaction description, must be submitted with the application. A copy of the agency's in house purchase order is not an acceptable substitute for the ITV with USAS transaction description. Submit the completed form along with the filing fee. The form may be mailed to the Notary Public Unit, P.O. Box 13375, Austin, Texas 78711-3375 or delivered to the James Earl Rudder Office Building, 1019 Brazos, Austin, Texas 78701. The secretary of state will issue an amended notary public commission upon filing of a completed application. Revised 07/09 Form 2305-NB 1 American LegalNet, Inc. www.FormsWorkFlow.com Form #2305-NB Rev. 07/2009 This space reserved for office use Submit to: SECRETARY OF STATE Statutory Documents Section P O Box 13375 Austin, TX 78711-3375 512-463-5705 Filing Fee: $10 APPLICATION FOR CHANGE OF NAME OF TEXAS NOTARY PUBLIC WITHOUT BOND Social Security No.: New Name: Last First Middle Suffix Agency Mailing Address: TX Street City State Zip Notary Mailing Address: TX Street City State Zip County of Residence: Name in which present commission is issued: Commission Expires: Statement Regarding Commission Select one of the following: A. My original notary public commission is included with this application. OR B. I no longer have my original notary public commission. I will perform all future notarial acts under the name specified on the amended commission. Attachments The following items are included with this application: 1. Original notary public commission, if option A above was selected; and 2. $10 filing fee. Execution I certify that the information provided in this Application for Change of Name as Texas Notary Public Without Bond 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 Notary Printed or typed name of Notary Form 2305-NB 2 American LegalNet, Inc. www.FormsWorkFlow.com