Notary Application

Name

This field is for validation purposes and should be left unchanged.

Class Date (New Notary - 1st Friday of every month. Notary Renewal - 1st & 3rd Wednesday of each month)(Required)

Are you a resident of Ohio?(Required)

Yes

No

How long have you lived in Ohio?

Drivers License #

Name(Required)

First Middle Last

Home Phone(Required)

Email(Required)

Address(Required)

Street Address City State ZIP Code

Age(Required)

Date of birth(Required)

Where were you born?(Required)

City

State

Country

If not in the US, Were you Naturalized?

Date

Court

City

Employed by(Required)

Occupation

Business Address

Street Address City State ZIP Code

Business Phone

Why do you want to become a Notary Public?(Required)

Have you ever applied for appointment as a Notary Public and been rejected?(Required)

Expiration of Current Commission(Required)

Is your current or previous commmission issued in a different name?(Required)

Yes

No

If yes, what is the full name on the commission

Have you ever been suspended or removed from the office of Notary Public?(Required)

Yes

No

Year

Reason

Signature of applicant(Required)