Maine > Secretary Of State > Notary
Request By Notary Public To Change Name And Or Address - Maine
| Request By Notary Public To Change Name And Or Address Form. This is a Maine form and can be used in Notary Secretary Of State . |
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Department of the Secretary of State Bureau of Corporations, Elections and Commissions Notary Public Section 101 State House Station Augusta, ME 04333-0101 Phone (207) 624-7650 - FAX (207) 287-6545 Request by Notary Public to Change Name and/or Address Expiration Date of your Notary Public Commission:______________________________ Effective date of the change of na me or address:_______________________________ Current name under which you are authorized to act as a Notary Public: _______________________________________________________ New name under which you will be authorized to act as a Notary Public: _______________________________________________________ Signature:__________________________________________________ Current home mailing and physical address (please provide complete address for both including zip code): _______________________________________________________ _______________________________________________________ (mailing address) _______________________________________________________ _______________________________________________________ (physical address, if different from above) E-mail address:______________________________ Other language fluency:_____________________________ Current town/city of residence:_____________ ___________ Date of Birth:__________________ Telephone numbers: Home:______________________Work:_____________________ IF YOU WISH TO RECEIVE A NEW NOTARY PUBLIC CERTIFICATE OF OFFICE SHOWING THE ABOVE CHANGE, PLEASE INCLUDE A COPY OF YOUR CERTIFICATE WITH THIS FORM. If you are filing a change of name, please include a photocopy of the paperwork authorizing the ch,angesuch as a marriage certificate or divorce decree.
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