Page 1 of 5 Pleas The applicant must complete this entire application and a ll questions must be answered completely Name of Applicant Please Type or Print your name This becomes your officia ID: 375270
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Page 1 of 5 StateMaineOfficetheSecretaryStateApplicationforNotaryPublicCommissionfor a I, (First name)(Middlenameorinitialif used)(Lastname) adultresidenttheStateMainewholeastyearsold,and (Town/CityofLegalResidence)request Homephone: Workphone: MailingAddress(ifdifferent): Datebirth: Gender:MaleFemale Otherlanguagefluency: (Pleaselistlanguage(s))mailAddress:youhaveeverbeenarenowcurrentlynotary Thissectionforofficeuseonly.NotaryPublic Commissionissued: Page 2 of 5 SectionPleaseanswerallquestions.NotarialLawandPracticesKnowledgeExaminationThefollowingquestionsaredesignedfamiliarizeyouwithsituationscommonlyfacedMaineNotariesPublic.Youranswerswillprovidepartialbasisgrantdenyyourrequestcommissioned.YoumayconsulttheNotaryPublicHandbookotherreferencematerialsassistansweringthesequestions.Youareaskednotarizedocument,whatstepswouldtake?NotaryPubliccommissionedin theStateMainemayperformdutiesoutsidethisState.receivedirectbenefitforthecompletionparticulartransaction,youmaynotarizeanydocumentsforthattransaction.TRUEFALSEconsideredconflictinterestperformnotarialact,otherthanmarriage,forimmediatefamilymember.TRUEFALSEWhichformsidentificationareacceptableverifyidentitywhenperformingnotarization?(Checkallthatapply) Stateissueddriver’slicensePassportSocialSecurityCardMilitaryCreditcardBirthCertificateMovieClubCardemployee,youmaynotarizeanydocumentsforyouremployercustomers.TRUEFALSENotaryPublic,areaskedperformweddingceremony.Whichthefollowingmustoccurwhensolemnizingthe marriage?(Checkonlyone)ministermustwitnessandsignthedocuments.TheMunicipalClerkmustwitnesstheceremonyandsignthepersonperformingtheceremony.TheSecretaryStatemustsignthelicense.Yousignthemarriagelicensethepersonperformingtheceremony.thefollowing,whichrecordsareyourequiredto keep?(Checkallthatapply)AllnotarialactsAllweddingsAllrequestsforyourservices,evennotperformtheserviceNonetheabove.TRUEFALSE Page 3 of 5 AfterappointmenttheofficeNotaryPublic,youarerequiredto sworn intoofficewhichthefollowingofficialsbeforeperforminganynotarialacts:LawyerNotaryPublicDedimusJusticeMunicipalClerkThepersonalappearanceof theindividualrequesting yourservicerequiredorderforyouperformnotarialact.whichthefollowingsituationsareyou,NotaryPublicallowedto givelegal advice?(Checkallthatapply)Never,unlessyouareattorney.Whenyoupreparelegaldocument.Whenyou knowtheinformationyougivecorrect.Whencompletingmarriagelicense,youmustuseblackinkpen.TRUEFALSETRUEFALSENotaryPublic"certify"publicrecorddocumentsuchbirthcertificate.Matchthefollowingwordswiththe correctdefinition.(Enterletterin theappropriateblankbelow.)TRUEFALSEWhatthebestwaylimityourliabilityandprotectthepersonrequestingyourservice?(Checkallthatapply) Makementalnotethetransaction.Makephotocopythenotarizeddocument.Keepboundrecordbookwiththedetailsthetransaction.Nonetheabove.thefollowing,whichtheproperwayacceptacknowledgement?(Checkallthatapply)telephonepersonalappearancefaxmailNonetheabove.Youremployerregulatewhenyoucanperformnotarialactsduringemploymenthours.TRUEFALSEAffidavit formaldeclarationbeforenotarypublic personsigningdocumentthattheexecutionthedocumenthis/herfreeactand deed. writtenstatementfactsmadevoluntarilyand confirmedtheoathaffirmationthepartymakingbeforeofficerauthorizedadministeroaths(likenotarypublic.) formaldeclarationunderpenaltyperjurythat certainstatementsaretrue.Thisequivalentandmaybe substitutedforoath. Anyformattestationpledgewhichperson signifiesthatsheconscienceandsenseresponsibilitySupremeBeingto thetruthfulnessforsomestatements. writtennotarialstatementthenotarypublic indicatingthatthedocumentwas swornaffirmed thesigneranyswornstatementaffidavit. TheuseembossingoptionalfornotarypubliccommissionedthisState.TRUEFALSESomeonepresentsyouwithdocumentnotarizewhichcontainsblankspaces;youshould(Checkallthatapply)MakenoteyourrecordbookLeavethesignerwhetherleaveblanksInsertyournamethenotarytheseblankspacesAdvisethesignertheconsequencesleavingblanksNonetheabovePleasecompletetheremaindertheapplicationthenextpagespriorsubmittingyourapplication. a. Jurat b. Acknowledgement c. Oath d. Affirmation Page 4 of 5 SectionMustsignedthepresencetheNotaryPublic. solemnly(swear)(affirm),underpenaltyperjury, thattheanswersthisapplicationaretrueandcompletethebestknowledge, and thatPERSONALLY,have completedthenotariallawand practices knowledgeexamination. *Your printed name above must match the printed name as itappearsthefrontthisapplication. SignatureApplicant)(Date)Thesignature on this pagebecomesyourofficial notarialsignature.StateMaine County Swornandsubscribedbefore Maine. (SignatureofNotaryPublic)(NotaryPublicSeal)(Printed NameofNotaryPublic)NotaryPublic,StateMaine commissionexpires (PLEASENOTE:TheNotaryPubliccannotthesameindividualsigningtheMaineregisteredvoter.Additionally,thesignaturethe municipalclerkregistrarvotersmustfromthecitytownwhichlive SectionMustcompleted theMunicipalClerk/RegistrarVotersresidenceMaine.beingtheMunicipalClerkand/or Registrar Voters,certifytheApplicantis aresidentthemunicipalitylisted,and affixthesealthemunicipality.(SignatureofClerk orRegistrar ofVoters)(Printed NameofClerk orRegistrarofVoters) NameMunicipality: (MunicipalSeal) Page 5 of 5 SectionMustcompletedregisteredvotertheStateMaine, other than the applicant or the Notary Publicin Section C registeredvotertheStateMaine,recommendtheappointment andattestthecapabilitytheapplicantperformthedutiesrequiredtheofficeMaineNotaryPublic. (SignatureofRegisteredVoter)(NameofMunicipality)Commissionfee:$50PleaseremitpaymentmadepayabletheMaineSecretaryState.Submitcompleted formto:SecretaryStateDivisionCorporations, UCCand CommissionsStateHouseStationAugusta,043330101TelephoneInquiries:(207)EmailInquiries:CEC.Notaries@Maine.govFormNo.Notary2/2020 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4