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Application For Amended Commission As A Notary Public-Change Of Employer County (Non-Resident Notaries Only) Comm 56 - Missouri
| Application For Amended Commission As A Notary Public-Change Of Employer County (Non-Resident Notaries Only) Form. This is a Missouri form and can be used in Notary Secretary Of State . |
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State of Missouri D WE S T ITE D AN DIV Jason Kander, Secretary of State X ESTO LE ED WE FA ID E PLURIB M UNU SALUS PO MDC PUL I SUPREM CCXX Print or Type 1. Name (This name must appear as it is signed in #7) 2. Home Address City 3. New Employer Address City 4. Daytime Phone Number 5. Missouri Commission Number 6. CHANGE IN EMPLOYER COUNTY (For Non-Resident Notaries ONLY) I hereby request the Secretary of State to issue an amended notary public commission changing my county of employment from County, Missouri, to Missouri, where I am presently employed, effective on the day of County . State Zip Code State Zip Code 7. Signature and Email Address of Applicant PAYMENT $5 Check or Money Order Enclosed (Payable to Director of Revenue) NAME AS IT APPEARS ON CREDIT CARD EXPIRATION DATE SIGNATURE Form Comm. 56 (11/10) American LegalNet, Inc. www.FormsWorkFlow.com LL US A Commissions PO Box 784, Jefferson City, MO 65102 Toll-Free (866) 223-6535 or (573) 751-2783 UN (Non-Resident Notaries Only) Application for Amended Commission as a Notary Public Change of Employer County (Application fee $5) Date of Birth (MM/DD/YYYY) (This signature must appear as it is typed or written in #1) Credit Card: Master Card Visa Discover American Express CARD NUMBER (16 Digits) Amended Application Instructions Employer County Change (Non-resident Notaries Only) 1. Name - You should print or type your name as you want it to appear on your commission certificate. You are required by law to use your full last name, while initials may be used for first and middle names. Date of Birth - Please provide your birth date in numerals: month/day/year. This is to confirm that applicants are at least eighteen years of age. 2. Residence Address - Please provide the address at which you reside. If your mail goes to a post office box, please include a street address after the PO Box number. Also give the city, state and zip code. 3. New Employer - Indicate new employer's name and address. 4. Daytime Phone - You are requested to provide a phone number where we can reach you BETWEEN THE HOURS OF 8:00 a.m. and 5:00 p.m., should we need to verify information given on the application in order to prevent the delay of returning the form to you for verification. 5. Missouri Commission Number - Please provide your commission number if you were commissioned after August 28, 2004. 6. Change in Employer County Enter the name and address of your new employer. Also include the new county and the effective date of employment. 7. Signature - Complete the form by adding your signature in the same name style you indicated in # 1 on the application. Please include your $5 application fee. Please include your previous notary certificate. You will receive a new certificate with your new information. Instructions Form Comm. 56 (11/10) American LegalNet, Inc. www.FormsWorkFlow.com
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