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Application for Michigan Notary Public Commission

Michigan DEPARTMENT OF STATE OFFICE OF THE GREAT SEAL Form 98 (Rev. 12/14) Application FOR Michigan Notary Public Commission (Please print legible or type; ALL fields must be completed or Application will be returned) 1. Full Name (first/middle/last): (must match your State driver s license or ID card) 2. Please indicate any previous and/or alias names: If none, please check box N/A 3. Driver s license or personal identification card number: - - - - Issuing state: 4. Residence address: (Must match license or ID file - include PO boxes, lot and Apt numbers) City: State: Zip: 5. Date of birth: 6. E-mail address: If none, please check box N/A 7. Business Street address: If none, please check box N/A City: State: Zip: 8.

michigan department of state office of the great seal form 98 (rev. 12/14) application for michigan notary public commission

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