NOTARY PUBLIC APPLICATION INSTRUCTIONS

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1 200 Mill ve. S., Suite 410 NOTRY PULIC PPLICTION INSTRUCTIONS s the premier full service notary supply company in Washington State we would like to offer our complete Notary Public processing service to you. Our service includes; the state required Notary Surety ond, filing of the bond with the state and the manufacturing of your seal or stamp. In addition to the basic requirements for becoming a notary we offer a full line of notarial supplies, Notary Errors and Omissions Insurance as well as regularly scheduled training sessions throughout the state. egin Your pplication Process in Three Easy Steps: 1. Complete the three page State Required Notary pplication. 2. Complete the enclosed order form. (This is where you select the seal or stamp you will use for your commission, pay for your State required Notary ond and the State filing fee of the bond. You may also order additional supplies and pay for a seminar or insurance on this form.) 3. , fax, or mail the application and order form to our office with the payment method of your choice. Once we receive your renewal request we will write your bond and send proof of bonding with the application fee to the state via UPS the next business day. t the same time we will send you your paid receipt and the original bond with instructions. Enclosed will also be information about how to protect yourself as a notary with Errors and Omissions Insurance & our notary training seminars. It will take the Notary Section of the State of Washington approximately 3-5 weeks to process your application and issue you a Notary License. y Law YOU must supply a copy of that license to us before we can begin manufacturing your new seal or stamp. Please allow 4-6 days for the manufacturing and shipping of your supplies.

2 OND INFORMTION Notary Public ppoinment/ Reappointment pplication This application is a: New application-complete this entire form (pages 2 through 4) Renewal before expiration date-complete sections and only (this page) For Validation only COMMISSON EXPIRTION DTE: pplicant information Notary ppointment Name (Name as you will sign notarizations and as you would like it to appear on your notary seal/certificate) See page 1 Instructions Social Security number required* irthdate (mm/dd/yyyy) Mailing address (PO ox or street including apartment/suite #, City, State, ZIP code) (rea code) Telephone number Full legal name (First, Middle, Last) no initials Check one I am a Washington resident I work or conduct business in Washington and am a resident of Oregon Idaho nswer the following Can you read and write English?... Yes No Have you ever been a Notary Public in the state of Washington?... Yes No If yes, under what names? *ll applicants are required by federal and state law to provide their Social Security number (SSN) for use in child support enforcement programs (42 U.S.C. 666(a)(13) and RCW ). It may also be used for education loan repayment programs and identification of records with similar names. Submission of your SSN is mandatory; failure to submit it will result in denial of your application. Personal data If you answer Yes, to any of the questions below, attach a detailed explanation. In this state or any other jurisdiction are you or have you: 1. Within the last 10 years, defaulted or been convicted of or entered a plea of no contest to a gross misdemeanor or felony crime? (Don t include traffic offenses.) Yes No 2. Currently under indictment, or is there a criminal complaint, charge, or information pending against you? Yes No 3. Within the last 10 years, had any action (fine, suspension, revocation, censure, surrender, etc.) taken against any professional or occupational license, certification, or permit held by you?..... Yes No 4. Within the last 10 years, had any civil court order, verdict, or judgment entered against you?..... Yes No

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4 Important! You (the Notary Public applicant) must complete this page in front of a Notary Public. If all of the instructions below are not followed correctly, you will have to complete and submit a new Declaration of pplicant and your Notary Public appointment will be delayed. Instructions for the applicant 1. The Notary Public will properly identify you and place you under oath. 2. fter the Notary places you under oath, you must: Swear to or affirm that the information in the Declaration of pplicant is true. Print your Notary ppointment Name on the Declaration exactly as it appears in section of your application. Sign the Declaration in front of the Notary, using your Notary ppointment Name exactly as it appears in section of your application. Date the Declaration in front of the Notary. Instructions for the Notary Public 1. Confirm the identity of the applicant and place him/her under oath. 2. Have the applicant swear to (or affirm) the information in the Declaration of pplicant. 3. Have the applicant sign and date the Declaration of pplicant. 4. Fill in the name of the county in which you are notarizing. 5. Date the Declaration of pplicant. This date must match the date the applicant signed. 6. Sign your name exactly as it appears on your stamp or seal. 7. Print your name under your signature. Your title is Notary Public. 8. Fill in the expiration date for your Notary Public appointment. 9. ffix your stamp or seal in the space indicated. Failure to follow any of these instructions by you or the Notary will result in the delay of your license. D Declaration of applicant I,, solemnly swear or affirm under penalty of Print your Notary ppointment Name exactly as shown in section of this application perjury that the personal information I have provided in this application is true, complete, and correct; that I have carefully read the materials available at the Notary Public website describing the duties of a notary public in and for the state of Washington; and, that I will perform to the best of my ability, all notarial acts in accordance with the law. I have carefully read the questions in the foregoing application and have answered them completely, and pursuant to RCW , I declare under penalty of perjury under the law of the state of Washington that my answers and all statements made by me herein are true and correct. Should I furnish any false information in this application, I hereby agree that such act shall constitute cause for the denial, suspension or revocation of my appointment as a notary public in the state of Washington. pplicant: sign here X in front of Sign using your Notary ppointment Name Date signed a notary State of Washington County of On this day,, appeared before me, Date pplicant full legal name signed this Declaration of pplicant, and swore (or affirmed) that he/she understood its contents and that its contents are truthful. Signature (Seal or stamp) Printed or stamped name Title My appointment expires NP (R/3/16)W Page 4 of 4

5 1 OLD STYLE IDEL METL EMOSSING SEL INSERT EMOSSING SELS 2 NEW STYLE IDEL HND HELD/DESK COMO EMOSSING SEL Complete Seal Insert Only 3 SEL IMPRESSION INKER (For use with the embossing seal only-lack) RUER STMPS 4 SELF-INKING IDEL STMPS 5 PRE-INKED SLIM STMPS W/O HNDLE C C 6 REGULR STYLE RUER STMPS (For Use With Stamp Pad) 7 INK PDS Does Not Include Stamp Pad. These stamps may also be used if working with Mylar and the Mylar stamp pad kit. For use on paper documents For use on mylar documents ll inked rubber stamps require re-inking on a regular basis. WRRNTY VOID IF STMP IS NOT RE-INKED USING PPROPRITE RND OF INK SIZE OF NOTRY STMPS COMPLIES WITH WSHINGTON STTE NOTRY LW 8 NS JOURNL OF NOTRIL CTS NS Soft Cover Journal NS Hard Cover Journal NOTRY JOURNLS The three most common Notarial acts require a statement from your customer regarding the contents of the document. (RCW ) FOR YOUR PROTECTION the customer signs your book in the appropriate section. DT / Date of ct Time of ct Type of Notarial ct: Individual cknowledgement cknowledgement Representative Type of Representative Capacity Verification on Oath or ffirmation Witness Signature Certifying a Copy Certifying an ct or Event Other IDENTIFICTION Name Printed ddress City Signature Type of Identification Identifying Numbers Type of Document INDIVIDUL CKNOWLEDGEMENT I,, affirmed to the Notary Public that I am the person named in the document, and that I have signed it as my free and voluntary act. REPRESENTTIVE CKNOWLEDGEMENT I,, affirmed to the Notary Public that I am authorized to sign the document as the of to be the free and voluntary act of such party. dditional Information: VERIFICTION ON OTH OR FFIRMTION I,, affirmed to the Notary Public that I am the person named in the document and I swear or affirm that the statements I have made are true. 9 STNDRD JOURNL OF NOTRIL CTS STNDRD Soft Cover Journal STNDRD Hard Cover Journal Standard journal should only be used in notarizing documents that are for in-office use only. EXMPLE: You only notarize the signatures of company officers. 10 NOTRY PRIVCY GURD Prudent notaries keep a journal which contains clients private information. Use of the Notary Privacy Guard not only protects the client, but also protects the Notary Public by limiting client s exposure.

6 TTORNEY & NOTRY SUPPLY pplication Order Form P.O. ox 2895 Renton, W Phone (425) Fax (425) THE FOLLOWING INFORMTION IS REQUIRED FOR SHIPPING Your Name: Day Phone #: Company Name: Office Mailing ddress: Suite: City: State: Zip Code: If the shipping address provided is incorrect, you will be billed for the correction fee. LOST SHIPMENTS WILL NOT E REPLCED TXLE NOTRY SUPPLIES PRICE QTY TOTL 1. Old Style Metal Embossing Seal Insert New Style Hand Held/Desk Combo Embossing Seal a. Complete Seal b. Insert Only Seal Impression Inker, with black or blue ink Self-Inking Ideal Stamps a. Round b. Rectangular c. Ink Pre Inked Slim Stamp, without handle a. Round b. Rectangular c. Ink Regular Style Stamp (stamp pad needed) a. Round b. Rectangular Ink Pads a. lack Stamp Pad 7.00 b. Mylar Ink Kit NS Notary Journal a. Soft b. Hard Standard Notary Journal a. Soft b. Hard Notary Privacy Guard Notary Fee Sign Finger Print Pad Self Inking Name/ppointment Expires Stamp (Up to 2 lines) Self Inking ttestation of a Copy Stamp Taxable Subtotal Shipping & Handling TXLE TOTL WITH SHIPPING & HNDLING Tax- Multiply Taxable Total with the Local Tax Rate Call for assistance or visit our website for your current Tax Rate TOTL SUPPLY ORDER WITH TX & SHIPPING Non-Taxable Required Items PRICE QTY TOTL Notary Surety ond (Required) State License Fee (Required) Paper Filing of Notary ond With the State Non-Taxable Optional Items Notary Training Seminar No Charge $10,000 Notary E&O Insurance (4 years) $15,000 Notary E&O Insurance (4 years) $25,000 Notary E&O Insurance (4 years) $30,000 Notary E&O Insurance (4 years) $50,000 Notary E&O Insurance (4 years) $100,000 Notary E&O Insurance (4 years) Total of Non-Taxable Items Total Supply Order with Tax & Shipping TOTL OF ENTIRE ORDER Ink Color lack lue Purple Red Green Payment Options Payment by Check: Make Check payable to.n.s., Inc. OR Credit Card Info VIS MC Discover Card Holder Name Card Holder Signature Card Number Expiration Date illing Zip Code 3 Digit Code Credit Card Charges Cannot e Cancelled Shipping Rates Commercial Residential $0-$10 (USPS) $2.50 $2.50 $11-$17 (USPS) $5.00 $5.00 $18-$30 (UPS) $6.50 $12.50 $31-$50 (UPS) $10.50 $14.50 $51-$70 (UPS) $13.00 $17.00 Over $70 call for correct charge SEND COMPLETED ORDER FORM WITH YOUR OND INFORMTION TO: ttorney & Notary Supply, Inc. PO ox 2895 Renton, W OR renewal@ansofwa.net

7 Did you know that there is more to notarizing than just filling in the blanks? notary is an impartial witness to the identity, signature and statement of the person appearing before the notary. This is why.n.s. teaches Washington State notary law. Every notarial act has specific actions which much be followed. Our notary seminars cover the standards for carrying out all notarial acts in Washington. Notaries are subject to criminal, civil and administrative penalties and your state required notary bond only protects the public you serve. Your only protection is proper training and insurance. Our seminar is a four hour session concentrating on Washington notary laws and standards. It is taught by practicing Washington Notaries. President, Judith Welsh, began offering notary seminars to educate Notaries on how to fulfill their notarial duties within the scope of the law after working with the Law Revision Committee in For over 25 years she has offered year round, statewide notary seminars as well as private group sessions. Vice President, Rebecca Jacob, joined Ms. Welsh in teaching notary seminars in Ms. Jacob has used her nearly 30 years of notarial experience to educate notaries on the standards practiced today and has co-written our updated notarial training manual. Seminar Sessions Have een Scheduled Statewide Early Sign up is recommended SEMINR SESSIONS are from 9:00 a.m. to 1:00 p.m. Check in begins at 8:30 a.m. REGISTRTION FEE for our four hour session is $ This fee includes all reference materials for our live class as well as a breakfast beverage service. No cancellations accepted within one week of the seminar, although a substitute may be sent.

8 SEMINR SCHEDULE LL SESSIONS EGIN T 9:00 am ND END T 1:00 pm SETTLE Tues., pr 17, 2018 WSHINGTON STTE CONVENTION CENTER 705 Pike St, Seattle TCOM Tues., May 8, 2018 TCOM CONVENTION CENTER 1500 roadway, Tacoma ELLEVUE Tues., Feb 13, 2018 HOTEL 116, COST HOTEL - ELLEVUE th ve NE, ellevue LYNNWOOD Tues., Mar 20, 2018 LYNNWOOD CONVENTION CENTER th ST SW, Lynnwood RENTON Tues., May 15, 2018 RED LION 1 South Grady Way, Renton YKIM/ SPOKNE RED LION T NME: HOME/MILING DDRESS: CITY: EMIL DDRESS: DY PHONE: (DO NOT USE OFFICE DDRESS) ZIP: NOTRY COMMISSION EXPIRTION DTE: ** ** CLL FOR PPLICTION FORMS, OR GO TO OUR WESITE TTENDING THE SEMINR DOES NOT MKE YOU NOTRY. YOU MUST COMPLETE THE SEPRTE PPLICTION PROCESS. I WILL TTEND ON (DTE): LOCTION: Enclose a check for $ payable to NS of W, Inc. LL FEES MUST E PID WITH REGISTRTION NO REFUNDS - THIS IS CONFIRMED RESERVTION Copy this form for your records. Send Registration and Fees to: TTORNEY & NOTRY SUPPLY P.O. ox 2895 Renton, W If you are paying by Credit Card Fax seminar@ansofwa.net Credit Card Info VIS MC Debit Credit Card Holder Name Card Holder Signature Card Number Expiration Date illing Zip Code 3 Digit uthorization Code Credit Card Charges Cannot be Cancelled

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