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Application For Appointment As Notary Public Or Justice Of The Peace NF-1 - Rhode Island
| Application For Appointment As Notary Public Or Justice Of The Peace Form. This is a Rhode Island form and can be used in Notary Secretary Of State . |
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Fee: $80.00 (4-year term) STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS Office of the Secretary of State Notary Public Section 100 North Main Street Providence, Rhode Island 02903-1335 APPLICATION FOR APPOINTMENT AS NOTARY PUBLIC OR JUSTICE OF THE PEACE To be executed and returned to the Secretary of State, together with the fee of $80.00. Applicant must be either a registered voter in the State of Rhode Island or an attorney who is a member of the Rhode Island Bar. All applicants, new or renewals, must complete section 1, section 2A or 2B as applicable, and section 3. NEW RENEWAL Date: ___________________ To the Governor of the State of Rhode Island: 1. All applicants must complete this section. Sign the application as you would to vote. I, (print or type name) _________________________________________________, the undersigned, residing at (number, street, city, state, zip),________________________________ __________________________________________________________ do hereby request appointment to the office of NOTARY PUBLIC (or JUSTICE OF THE PEACE) and enclose herewith $80.00, the required fee for such commission. ________________________________________________ SIGNATURE OF APPLICANT 2. You must be a registered voter in the State of Rhode Island or an attorney who is a member of the Rhode Island Bar. All applicants, new or renewals, must have section A completed unless they are members of the Rhode Island Bar. Members of the Bar must complete section B. A. Take or send the application to the Board of Canvassers in your city or town. The following is to be signed by a member or staff of the Board of Canvassers, certifying that you are a registered voter. I HEREBY CERTIFY that the above applicant was, on the above date, a duly qualified elector of the City/Town of _______________________________________. ________________________________________________ SIGNATURE OF MEMBER OR STAFF OF THE BOARD OF CANVASSERS B. A member of the Rhode Island Bar is not required to have the application certified by the Board of Canvassers. However, a copy of your current Rhode Island Bar card or a certified copy of your Certificate of Admission to the Rhode Island Bar must be filed with this application. I, the above applicant, am a member of the Rhode Island Bar. __________________ ________________________________________________ BAR NUMBER SIGNATURE OF APPLICANT IF A MEMBER OF RI BAR PLEASE CONTINUE ON BACK <<<<<<<<<********>>>>>>>>>>>>> 2 3. All applicants must complete this section and have it notarized. CERTIFICATE OF ENGAGEMENT ON COMMISSION Official Signature of the Officer Engaged: ________________________________________________ Signature as it will appear on commission _________________________________________________________ Write the words NOTARY PUBLIC or JUSTICE OF THE PEACE ________________________ COUNTY, In the City/Town of ___________________________ and County and State aforesaid, on the ______ day of _________________, 20___, personally came_________________________________________, and made oath/affirmation to support the Constitution of the United States and the Constitution and Laws of Rhode Island, and faithfully and impartially discharge the duties of the officeNOT of ARY PUBLIC or JUSTICE OF THE PEACE for said State according to the best of his/her abilities. ________________________________________________ NOTAY PR UBLIC or JUSTICE OF THE PEAE C Commission expiration date: ______________________ Personally known by me Produced identification Pursuant to state law, the filing fee is $80.00. Checks must be made payable to the Secretary of State. Return application with filing fee to Office of the Secretary of State, Notary Public Section, 100 North Main Street, Providence, RI 02903-1335. The Notary Section can be reached at 222-1487, from 8:30 am to 4:30 pm, Monday through Friday. You will receive your Notary Commission in the mail in approximately three (3) weeks. Your term will expire four (4) years from the date of commission. A renewal form will be mailed to you at the address listed, so please contact this office if you change your address. NOTE: In the State of Rhode Island, Justices of the Peace MAY NOT perform marriage ceremonies. LOCAL BOARDS OF CANVASSERS Barrington Town Hall, 283 County Rd. 247-1900 Newport City Hall, 43 Broadway 846-9600 Bristol Town Hall, 10 Court St. 253-7000 New Shoreham Town Hall, Old Town Rd. 466-3200 Burrillville Town Hall, 105 Main St.,Harrisville 568-4300 North Kingstown Town Hall, 80 Boston Neck Rd. 294-3331 Central Falls City Hall, 580 Broad St. 727-7450 North Providence Town Hall, 2000 Smith St. 232-0900 Charlestown Town Hall, 4540 S. County Trl. 364-1200 North Smithfield Town Hall, 1 Main St., Slatersville 767-2200 Coventry Town Hall, 1670 Flat River Rd. 822-9150 Pawtucket City Hall, 137 Roosevelt Ave. 722-1637 Cranston City Hall, 869 Park Ave. 461-1000 Portsmouth Town Hall, 2200 East Main Rd. 683-3157 Cumberland Town Hall, 45 Broad St. 728-2400 Providence City Hall, 25 Dorrance St. 421-0495 East Greenwich Town Hall, 111 Peirce St. 886-8602 Richmond Town Hall, 5 Town House Rd., Wyoming 539-2497 East Providence City Hall, 145 Taunton Ave. 435-7502 Scituate Town Hall, 195 Danielson Pike, North Scituate 647-7466 Exeter Town Hall, 675 Ten Rod Rd. 294-3891 Smithfield Town Hall, 64 Farnum Pike, Esmond 233-1000 Foster Town Hall, 181 Howard Hill Rd. 392-9200 South Kingston Town Hall, 180 High St., Wakefield 789-9331 Glocester Town Hall, 1145 Putnam Pike 568-6206 Tiverton Town Hall, 343 Highland Rd. 625-6700 Hopkinton Town Hall, 1 Town House Rd. 377-7777 Warren Town Hall, 514 Main St. 245-7340 Jamestown Town Hall, 93 Narragansett Ave. 423-9804 Warwick City Hall, 3275 Post Rd. 738-2000 Johnston Town Hall, 1385 Hartford Ave. 553-8856 West Greenwich Town Hall, 280 Victory Hwy. 397-5016 Lincoln Town Hall, 100 Old River Rd. 333-1100 West Warwick Town Hall, 1170 Main St. 822-9200 Little Compton Town Hall, 40 Commons 635-4400 Westerly Town Hall, 45 Broad St. 348-2500 Middletown Town Hall, 350 East Main Rd. 849-5540 Woonsocket City Hall, 169 Main St. 762-0027 Narragansett Town Hall, 25 Fifth Ave. 789-1044 FOR OFFICIAL USE NF.No rmFo -1 Revised: 05/00 Reviewed by: Check #:
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