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APPLICATION FOR NOTARY PUBLIC COMMISSION

form 11NP001 Revised 7/2021 Please type or print in ink. Name will appear on certificate as it is entered on this form . This form is designed to be completed and printed from your computer. You cannot save the form on your computer unless you havethe appropriate software. Fields marked with an asterisk (*) are required. Return completed APPLICATION and the $ fee to theSecretary of State, Business Services Division, Box 136, Jackson, MS you do not submit your bond within (60) sixtydays, your APPLICATION will be in lapse status and applicant will have to start the NOTARY process is a New Current COMMISSION Expiration Date: NOTARY ID#:_____ (Check only one) (Current COMMISSION ) Legal Name of Applicant: *_____ COMMISSION Name of Applicant:*_____ Applicant s name will appear on NOTARY COMMISSION exactly as entered for COMMISSION Name of Applicant above.

Form 11NP001 Revised 7/2021 Please type or print in ink. Name will appear on certificate as it is entered on this Form. This form is designed to be . completed and printed from your computer. You cannot save the form on your computer unless you have the appropriate software. Fields marked with an asterisk (*) are required.

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