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Notary Public Application For Commission 500 - Oregon
| Notary Public Application For Commission Form. This is a Oregon form and can be used in Notary Secretary Of State . |
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Notary Qualification To be a notary public in Oregon, you must meet the following qualifications, at the time of application: (A background check is conducted on all applications for a notary public commission). Be 18 years of age or older Be a resident of the State of Oregon (You may also qualify if you are a resident of California, Idaho, Nevada, or Washington and carry on a trade or business or are regularly employed within the State of Oregon) Be able to read and write the English language Be of good moral character Not have had a notary commission revoked for official misconduct during the previous 5 years Complete a 3 hour Notary training course (not required for current Oregon Notaries with an active commission at the time the new application is received in our office.) Not have been convicted of a felony, or of a lesser offense incompatible with the duties of a notary public, during the previous 10 years Good moral character means character other than that which reflects moral turpitude and conduct which respect for the rights of others and for the laws of the state and the nation. To be relevant to deciding whether Conviction of a lesser offense incompatible with the duties of a notary public means OAR 160-100-0610(67) shall mean having been convicted in any court of the State of Oregon or any other state or federal jurisdiction of one of the crimes listed below or any comparable crime: o Any misconduct identified of the notary offenses listed in ORS 194.990 o Compounding a felony (ORS 162.335) o Criminal impersonation (ORS 162.365) o Criminal possession of a forged instrument in the 2nd degree (ORS 165.017) o Criminal simulation (ORS 165.037) o False swearing (ORS 162.075) o Falsifying business records (ORS 165.080) o Forgery in the 2nd degree (ORS 165.007) o Fraudulently obtaining a signature (ORS 165.042) o Giving false information to police officer for a citation (ORS 162.385) o Initiating a false report (ORS 162.375) o Issuing a false financial statement (ORS 165.100) o Misapplication of entrusted property (ORS 165.095) o Misuse of confidential information (ORS 162.425) o Obstructing governmental or judicial administration (ORS 162.235) o Obtaining execution of documents by deception (ORS 165.102) o Simulating legal process (ORS 162.355) o Tampering with physical evidence (ORS 162.295) o Tampering with public records (ORS 162.305) o Unsworn falsification (ORS 162.085) o Any other offense of a similar nature to the above listed crimes, which is incompatible with the duties of a notary public 500a (03/11) American LegalNet, Inc. www.FormsWorkFlow.com DO NOT Submit this form & fee more than 2 1/2 months before your commission expires. If you do your $40.00 fe will not be refunded. This Space For Notary Office Use Only MAIL TO: STATE OF OREGON Corporation Division Notary 255 Capitol Street NE, Suite 151 Salem, OR 97310-1327 503-986-2593 FAX: 503-986-2300 www.FilingInOregon.com/notary Test Questions This Space For Notary Office Use Only NOTARY PUBLIC APPLICATION FOR A COMMISSION PLEASE TYPE OR PRINT LEGIBLY IN BLACK OR DARK BLUE INK. ALL SECTIONS MUST BE COMPLETED. In keeping with Oregon Revised Statute 192.410-192.595, the information on this application is public record. 1. Print Commission Name: (As proven by ID) First Middle or Initial Last 2. Full Legal Name: (First, Middle, and Last) (No Initials) 3. Other Names: (Including previous last names, commission names, and nicknames) 6. Date of birth: (mm/dd/yyyy) 7. Address where notary materials should be mailed: (City, State, Zip code) 8. Employer Business Name and Address: (City, State, Zip code) 4. Home or Cell Phone Number: 9. Home Street Address: (City, State, Zip code) Do Not use PO Box or PMB ( ( ) ) 5. Daytime or Work Phone Number & Extension: 10. Do you qualify to be a notary public in the State of Oregon pursuant to ORS 194.022, including no convictions for a felony, or certain lesser offenses in the last 10 years? (see form 500a or http://www.filinginoregon.com/notary/qualify.htm) YES NO 11. Have you ever applied to be an Oregon notary public? YES NO If yes, most recent commission name and expiration date if known: 12. Provide Notary Education Identification Number (located on the Certificate of Education) or current (active) Notary Commission Number. Required: Effective July 1, 2006 13. OATH OF OFFICE (Applicant must sign before a notary public.) I, , do solemnly (swear) (affirm), under penalty of perjury, that the answers to all questions on this application are true and complete to the best of my knowledge, and I, PERSONALLY, have completed the notarial examination to the best of my ability, and I understand that my signature on the notarial applica tion is my consent for criminal record investigation pursuant to ORS 194.024; AND, I do solemnly (swear) (affirm) that upon appointment, I will support the Constitution and laws of the United States and the State of Oregon, and I will faithfully discharge the duties of Notary Public in and for the State of Oregon according to the best of my ability. X Official Signature (Applicant Signature) State of County of Subscribed and (sworn) (affirmed) before me by (Print Commission Name of Applicant) this (day) day of (month) (year) . Notary Public Affix Official Seal 500 (03/11) Oregon (Signature) American LegalNet, Inc. www.FormsWorkFlow.com
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