Notary Application Form

I. Personal Information

Name: [Your Name]
Date of Birth: [Your Date of Birth]
Social Security Number: [Your Social Security Number]
Phone Number: [Your Phone Number]
Email Address: [Your Email Address]

II. Qualifications

Education Background:
[Bachelor of Science in Business Administration]
[University of Science and Business]
[2050]

Professional Experience:
[Senior Accountant]
[5 years]

Notary Training:
[Notary Public Training Program]
[Notary Academy]
[March 15, 2053]

III. Legal Background

Criminal History:
Have you ever been convicted of a felony? [Yes/No]
Civil History:
Have you ever been involved in civil litigation related to fraud or dishonesty? [Yes/No]

IV. References

Please provide the contact information for two professional references:

Reference 1:
Name: [Name of Senior Manager]
Title/Position: [Senior Manager]
Phone Number: [Phone Number of Senior Manager]

Reference 2:
Name: [Name of Human Resource Director]
Title/Position: [Human Resources Director]
Phone Number: [Phone Number of Human Resources Director]

V. Declaration

I, [Your Name], solemnly declare that the information provided in this application form is true and accurate to the best of my knowledge. I understand that any false statements made may result in the denial of my application or revocation of my notary commission.

VI. Affirmations

I hereby affirm that all information provided in this application is true and accurate to the best of my knowledge.
I understand that any false statements or omissions may result in the denial, revocation, or suspension of my notary commission.
I agree to abide by all laws, regulations, and ethical standards governing notarial acts in the State of [State].

VII. Signature

This certificate has been formally finalized and authenticated directly under my hand and officially stamped with my seal on the specified date of [Date].

Printed Name of Applicant: [Your Name]
Date: [Date Signed]

Printed Name of Notary Public: [Notary Public Name]
Date: [Date Signed]
Notary Seal (if applicable): [Seal]