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PAUL D. PATE Application for - Iowa

PAUL D. PATE Application for Secretary of State Commission as State of iowa Notary Public Read instructions before completing this Application . Please type or print information clearly. 1. Applicant s Name (as it will appear on the commission): _____ First Middle (Optional) 2. Applicant s Home Contact information : _____ House Number Street Name City State ZIP Code _____ _ Home Phone Number Home Email Address 3.

Please type or print information clearly. 1. Applicant’s Name (as it will appear on the commission): ... Qualifications: Check boxes to indicate whether applicant meets all the requirements as stated in Iowa Code section . 9B.21(2) and administrative rules in 721-chapter 43, and whether applicant is a resident of Iowa, or resident of another ...

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