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Application And Declaration For Notary Public - Georgia
| Application And Declaration For Notary Public Form. This is a Georgia form and can be used in Notary Public Superior Court Gwinnett Local County . |
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APPLICATION AND DECLARATION FOR NOTARY PUBLIC GEORGIA, GWINNETT COUNTYTo the Honorable Tom Lawler, Clerk of Superior Court of said County: I, the undersigned, do hereby submit my application to be a Notary Public under the provisions of theOfficial Code of Georgia, Sections 45-17-5, 45-17-6, 45-17-7, as amended and show that:(1) I reside in Gwinnett County at the address of: _________________________________________________ ______________________________________________________________________________________(2) I am at least 18 years of age; and (3) I can read and write the English Language; and(4) I ! (have) ! (have not) had a denial, revocation, suspension, restriction or resignation of a notary commission held by me, and that I ! (have) ! (have not) been convicted of a criminal act, including any plea of nolo contendere. (Not to include minor traffic violations.) (If you checked have to either of the above, provide complete details on the reverse of the application and sign same.) I, ___________________________________________, do solemnly swear or affirm under penalty of perjury that the personal information I have written in this application is true, complete and correct. X________________________________________________ APPLICANTSTATE OF GEORGIA GWINNETT COUNTY On this _______________ day of __________________________, 20 ______, before me appeared___________________________________________________________________, the person who signed theproceeding declaration of applicant in my presence and who swore or affirmed that _____________ (he/she)understood the document and freely declared it to be truthful. __________________________________________________ NOTARY PUBLIC Affix seal and expiration date.ENDORSEMENT (1) I, ______________________________________________, being 18 years of age or older and a resident ofGwinnett County, believe the applicant for Notary Public commission, ______________________________________________________________________, who is not related to myself, to be a person of integrity, good moralcharacter, and capable of performing notarial acts. DATE: _______________________ X________________________________________________ __________________________________________________ __________________________________________________ Endorsers signature and home addressREVISED 12-02 1 <<<<<<<<<********>>>>>>>>>>>>> 2(2) I, ______________________________________________, being 18 years of age or older and a resident ofGwinnett County, believe the applicant for Notary Public commission, ______________________________________________________________________, who is not related to myself, to be a person of integrity, good moralcharacter, and capable of performing notarial acts. DATE: _______________________ X________________________________________________ __________________________________________________ __________________________________________________ Endorsers signature and home addressAPPOINTMENT (TO BE COMPLETED BY CLERKS OFFICE) Having complied with all the regulations required by law to become a Notary Public, and it appearing that saidapplicant is at least 18 years of age, of good moral character and integrity, and qualified to perform notarial acts, it ishereby ordered that said applicant be and is hereby appointed Notary Public, as prayed for, upon said applicanttaking and subscribing the oath as prescribed by law. DATE OF APPOINTMENT: ___________________________________DATE OF TERMS: ___________________________________________AGE: ____________________ SEX: _____________________________PHONE: ______________________ ________________________ Home Work OATH OF OFFICE I, ____________________________________________________________________, do solemnly swear or affirmthat I will well and truly perform the duties of a Notary Public to the best of my ability, and I further swear or affirmthat I am not the holder of any public money belonging to the state and unaccounted for, so help me God. __________________________________________________Sworn to and subscribed before me This _______________ day of _________________________, 20________.______________________________________________________________DEPUTY CLERK Gwinnett County Superior Court REVISED 12-02 2
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