Information about http://soswy.state.wy.us/Forms/NotariesPublic/WYNotaryApp.pdf

Wyoming Notary Public Commission Application …

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Language: english
Created: Mon Jun 16 16:22:53 2008
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       Wyoming Notary Public Commission Application
                                                     (W.S. 32-1-107)

Instructions: Fill in all blanks, using "NA" if not applicable. Type or print clearly.

1. Commission Name Style (type or print name to exactly match signature below.)           2. County of Residence


3. Gender                        4. Last Name                     5. First Name           6. Middle Name

   Male          Female


7. Residential Address (street/route)         8. City                      9. Zip Code       10. Home Phone


11. Mailing Address (where notary information will be mailed)              12. City          13. Zip Code


14. Place of Employment (name & address)          15. City                 16. Zip Code      17. Business Phone




18. I am applying for:

        a new commission; or

        a renewal of my current commission. My current commission expiration date is: ___________________


19. Have you ever been a Wyoming notary?

       Yes, under the name of ______________________________ in ________________________ County.

        No.



Certification: please read, sign, and date.

I certify that I am 18 years of age or older, able to read and write the English language, and an actual
resident of the state of Wyoming and of the County for which I am making application.

I further certify that I understand the duties and responsibilities imposed on notaries public under
Wyoming law and understand that breach of said responsibility may result in criminal penalties including
imprisonment.




_______________________________________                                      _____________________________
Signature of applicant (must match item #1 above)                            Date

Filing Fee: $30.00 (make checks payable t "Secretary of State")
Return application and filing fee to:

                                                   Notary Officer
                                            Secretary of State's Office
                                    State Capitol Building, 200 West 24th Street
                                           Cheyenne, WY 82002-0020
                                                 Ph. 307.777.5335