BRK-RBNP
Renewal "BASIC" Notary Package

*Ink Color

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*Notary Stamp/Seal

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*E&O LIMIT

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*Name (Type your name EXACTLY as you will sign documents as a Notary Public.)

*Name on Most Recent Commission

*Most Recent Commisson Number

*Most Recent Commission Expiration Date

List of former name(s), if any (e.g. name changed due to marriage, etc.)

*Resident Street Address (P.O. Boxes are NOT acceptable.)

*City of Residence

*State of Residence

*Zipcode of Residence

*County of Residence

*Are you a resident of Oklahoma

-- Please Select --No Yes

If no, Employment Street Address (P.O. Boxes are NOT acceptable.)

If no, Employment City

If no, Employment County

If no, Employment Zipcode

*Applicant's Email Address

*Applicant's Daytime Telephone

*By typing my full name below, I, the undersigned notary applicant, declare the following statements to be true: A) I am 18 years of age or older; and B) I have never been convicted of a felony; and C) I am able to read and write in English. I also hereby

*By typing my full name below, I, the undersigned, hereby apply for appointment as a Notary Public in and for the State of Oklahoma and further state the information contained in this application is true and correct.

* Required Fields