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Application For Appointment As A Notary Public N-1 - West Virginia
| Application For Appointment As A Notary Public Form. This is a West Virginia form and can be used in Notary Public Secretary Of State . |
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Secretary of State Building 1, Suite 157-K 1900 Kanawha Blvd. East Charleston, WV 25305-0770 Website: www.wvsos.com SECRETARY OF STATE STATE OF WEST VIRGINIA NOTARY ADMINISTRATOR Tel: (304) 558-6000 Fax: (304) 558-0900 Toll Free: 1-866-SOS-VOTE Email: notary@wvsos.com APPLICATION FOR APPOINTMENT AS A NOTARY PUBLIC To become a West Virginia notary public, follow these steps carefully: 1. Complete all four sections of this application form. If you omit part, or don't sign and have your oath notarized, the form will be returned to you. 2. Send the application and a check or money order for $52.00 to the attention of the Notary Administrator at the Secretary of State's address listed above. Make checks payable to "Secretary of State." 3. YOU ARE NOT AUTHORIZED TO ACT AS A NOTARY UNTIL ALL STEPS ARE COMPLETED AND YOU HAVE RECEIVED A CERTIFICATE OF APPOINTMENT SIGNED BY THE GOVERNOR. If your application is approved, you will receive a letter containing further instructions. When you receive the letter, read it carefully and immediately follow those directions. If you do not receive that letter within three weeks, please call the Notary Administrator is 558-6000 to make sure we have received your application. Section 1: APPLICANT'S INFORMATION (Please type or print in ink.) Print your exact name as you will enter it whenever you perform a notarial act [middle names may be abbreviated or omitted]. Give your social security number. Give the WV mailing address you will use on your seal: Use a mailing address and zip code where you can receive mail. Use no more than three lines. If this is a business address, include the company name. Government notaries -- use agency name and address. If you have been a West Virginia notary before, give the expiration date of your last notary commission. Please answer YES or NO to the following questions: 1.________ Are you a citizen of the United States? _______ MALE Daytime Phone # _______FEMALE 2. ________ IF you answered "NO" to #1, are you a citizen of a country that permits American citizens to become notaries there? If yes, give name of country. ___________ 3. ________ Are you 18 years old or older? 4. ________ Are you presently under conviction of a felony? ("Under conviction" includes probation and/or parole.) 5. ________ Are you able to read and write English? 6. ________ Has your commission as a notary been revoked during the last 10 years? 7. ________ Are you a state or local government employee applying to become a notary public only for and in behalf of your government office? If you answer "YES," give your position title and the name of the office below. To have the fee waived, a letter from the head of your office certifying that the application is made for the purposes of the office must be attached. Federal employees are not eligible. (your title) Form N-1 (name of state or local government office) American LegalNet, Inc. www.USCourtForms.com Rev. 1/05 Section 2: ENDORSER'S STATEMENTS This section must be completed by three qualified electors of West Virginia. A "qualified elector" of West Virginia is a citizen eligible to register to vote in the state. To be eligible, a citizen must be (a) a United States citizen, (b) a resident of West Virginia for at least 30 days, and (c) 18 years of age or older. I, ________________________________(name of endorser), a qualified elector of West Virginia, believe to the best of my knowledge, the applicant is a person of good moral character and integrity and capable of performing notarial acts. Endorser's signature ___________________________________________________________________________ Address ____________________________________________________________________________________ I, ________________________________(name of endorser), a qualified elector of West Virginia, believe to the best of my knowledge, the applicant is a person of good moral character and integrity and capable of performing notarial acts. Endorser's signature ___________________________________________________________________________ Address ____________________________________________________________________________________ I, ________________________________(name of endorser), a qualified elector of West Virginia, believe to the best of my knowledge, the applicant is a person of good moral character and integrity and capable of performing notarial acts. Endorser's signature ___________________________________________________________________________ Address ____________________________________________________________________________________ Section 3: APPLICANT'S OATH Every applicant for appointment and commission as a notary public shall take the following oath in the presence of a person qualified to administer an oath in West Virginia. (Qualified persons include notaries public, clerks of court, county commissioners and judges). SEAL OF NOTARY GIVING OATH TO APPLICANT I, ________________________________(printed name of applicant), solemnly swear or affirm, under penalty of perjury, that the answers to all questions in this application are true, complete, and correct; that I have carefully read the notaries public law of West Virginia; and, if appointed and commissioned as a notary public, I will perform faithfully, to the best of my ability all notarial acts in accordance with the law. APPLICANT SIGN HERE ----> __________________________________________________ Subscribed and sworn or affirmed before me this _________day of ________________, ___. I, the undersigned, further certify that this applicant IS KNOWN TO ME to be the applicant and elector who executed this application for appointment and commission as a notary public and acknowledged to me that he or she executed the same for the purposes herein stated. Signature of notary or official Commission expires Section 4: Sign your name in the box below exactly as you entered it in Section 1: APPLICANT SIGN HERE ---->ΓΏ American LegalNet, Inc. www.USCourtForms.com PRINT THIS COPY, THEN CLICK HERE TO RESET.
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