Florida Notary Application Our application wizard makes it easy for you to complete your Florida Notary application and bond form without errors! You'll be able to save it to your NNA profile and print at your convenience, or download a blank application. When completed, you must PRINT, SIGN AND MAIL your application and bond form to the NNA. 1Applicant Information Notary Name Use your full legal name. This is the name that will appear on your Notary commission, bond, and seal. Required * This is the name in which your commission, bond, and notary seal will be issued: First Name * Middle Name Last Name * Personal Information Indicate Race Your date of birth must match state records Include your Florida Drivers License number or number from another Florida state-issued ID. If using your Driver's License information, make sure all 12 digits are provided Required * Sex * Male Female Date of Birth * Race * Asian Black or African American Native American or Alaska Native White Other Other Race * Drivers License / State Issued ID * Verify Drivers License / State Issued ID * Social Security Number * Verify Social Security Number * The disclosure of a Florida notary public applicant’s social security number is expressly required by Fla. Stat. §117.01(2) and is imperative for processing notary public commission applications. Please be advised that social security numbers are only used for processing the notary application and are exempt from disclosure pursuant to Fla. Stat. §119.071(5)(a)5. Home Address (no PO Boxes) The State of Florida requires a physical address; no PO boxes are accepted Required * Street * City * State * Florida County * Select County Alachua Baker Bay Bradford Brevard Broward Calhoun Charlotte Citrus Clay Collier Columbia DeSoto Dixie Duval Escambia Flagler Franklin Gadsden Gilchrist Glades Gulf Hamilton Hardee Hendry Hernando Highlands Hillsborough Holmes Indian River Jackson Jefferson Lafayette Lake Lee Leon Levy Liberty Madison Manatee Marion Martin Miami-Dade Monroe Nassau Okaloosa Okeechobee Orange Osceola Palm Beach Pasco Pinellas Polk Putnam Saint Johns Saint Lucie Santa Rosa Sarasota Seminole Sumter Suwannee Taylor Union Volusia Wakulla Walton Washington ZIP Code * Employment Information You're required to provide your employment status, and the name of your employer at the time of application. If self-employed, note under employer. Required * Employed Unemployed Retired Place of Employment * Business Street Address * City * State * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington DC West Virginia Wisconsin Wyoming County * Select County Alachua Baker Bay Bradford Brevard Broward Calhoun Charlotte Citrus Clay Collier Columbia DeSoto Dixie Duval Escambia Flagler Franklin Gadsden Gilchrist Glades Gulf Hamilton Hardee Hendry Hernando Highlands Hillsborough Holmes Indian River Jackson Jefferson Lafayette Lake Lee Leon Levy Liberty Madison Manatee Marion Martin Miami-Dade Monroe Nassau Okaloosa Okeechobee Orange Osceola Palm Beach Pasco Pinellas Polk Putnam Saint Johns Saint Lucie Santa Rosa Sarasota Seminole Sumter Suwannee Taylor Union Volusia Wakulla Walton Washington ZIP Code * Contact Information Provide at least one phone number. Write NONE in a field if not applicable. Required * Email Address * Home Phone * Business Phone * Business Extension (if applicable) Mail Materials to: Home Business Other Street / PO Box * City * State * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington DC West Virginia Wisconsin Wyoming ZIP Code * 2State Information Required * 1. Are you a legal resident of Florida? * Yes No Not Eligible You answered No. You are not eligible to apply for a notary commission. Legal residency must be maintained throughout the appointment. Change Answer OK, Cancel Application 2. Are you a United States citizen? * Yes No If No, you must submit a recorded Declaration of Domicile. Obtain this document from your County Courthouse. 3. Are you a wartime veteran with a disability rating of 50 percent or more? * Yes No If Yes, you must submit a written request for the fee reduction and provide proof of exemption. 4. Are you now or have you ever been commissioned a Notary Public in the State of Florida? * Yes No If No, you must complete a 3 hour Notary education course and submit a signed certificate of completion. Commission Expiration Date Commission Number * Name In Which Your Commission Was Issued * 5. Have you held any professional licenses or commissions (other than Notary Public) in Florida during the past 10 years? * Yes No If Yes, please list (separate with commas) Have any been revoked? Yes No If Yes, you must submit a written statement about the nature of the action and any supporting documentation, such as a copy of the Final Order from the regulating agency 6. Have you been disciplined by a regular agency, including the Florida Bar, and including disciplinary action that is confidential? * Yes No If Yes, you must submit a written statement about the nature of the action and any supporting documentation, such as a copy of the Final Order from the regulating agency 7. Have you been convicted of a felony or have you had an adjudication of guilt withheld for a felony offense? * Yes No If Yes, you must submit a written statement of the nature of the offense(s), a copy of the court judgment and sentencing order. If convicted, you must submit a certificate of Restoration of Civil Rights. 8. Are you currently on probation? * Yes No 3Affidavit of Character Required * This section will be signed by a person who has known you for at least one year and is confirming that you are of good character. They may not be related to you (your spouse may not sign). Please enter his/her information below: First Name * Last Name * Street * City * State * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington DC West Virginia Wisconsin Wyoming County * Select County Alachua Baker Bay Bradford Brevard Broward Calhoun Charlotte Citrus Clay Collier Columbia DeSoto Dixie Duval Escambia Flagler Franklin Gadsden Gilchrist Glades Gulf Hamilton Hardee Hendry Hernando Highlands Hillsborough Holmes Indian River Jackson Jefferson Lafayette Lake Lee Leon Levy Liberty Madison Manatee Marion Martin Miami-Dade Monroe Nassau Okaloosa Okeechobee Orange Osceola Palm Beach Pasco Pinellas Polk Putnam Saint Johns Saint Lucie Santa Rosa Sarasota Seminole Sumter Suwannee Taylor Union Volusia Wakulla Walton Washington ZIP Code * Home Phone * Work Phone * 4Oath of Office / Memorandum Required * I do solemnly swear (or affirm) that I will support, protect, and defend the Constitution and Government of the United States and of the State of Florida; that I am duly qualified to hold office under the Constitution of the state; that I have read Chapter 117, Florida Statutes, and any amendments thereto, and know the duties, responsibilities, limitations, and powers of a notary public; and that I will well and faithfully perform the duties of Notary Public, State of Florida, on which I am now about to enter. So help me God* UNDER PENALTY OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING APPLICATION AND OATH, AND THAT THE FACTS STATED THEREIN ARE TRUE. I accept the Office of Notary Public, State of Florida. * Yes No *Note: If you affirm, you may omit the words "So help me God." Fla. Stat. §92.52. AS A GENERAL MATTER, APPLICATIONS FOR ALL POSITIONS WITHIN STATE GOVERNMENT ARE PUBLIC RECORDS, WHICH MAY BE VIEWED BY ANYONE UPON REQUEST. HOWEVER, THERE ARE SOME EXEMPTIONS FROM THE PUBLIC RECORDS LAW FOR IDENTIFYING INFORMATION RELATING TO CERTAIN ENUMERATED PERSONS, INCLUDING, BUT NOT LIMITED TO, PAST AND PRESENT LAW ENFORCEMENT OFFICERS AND THEIR FAMILIES, VICTIMS OF CERTAIN CRIMES, ETC. (SEE SECTION 119.071, FLORIDA STATUTES) IF YOU BELIEVE AN EXEMPTION FROM THE PUBLIC RECORDS LAW APPLIES TO YOUR FLORIDA NOTARY PUBLIC COMMISSION APPLICATION SUBMISSION, PLEASE OBTAIN A PUBLIC RECORDS EXEMPTION FORM FROM THE FLORIDA DEPARTMENT OF STATE BY ACCESSING THE FOLLOWING LINK AND FOLLOWING THE INSTRUCTIONS ON THE FORM: https://dos.myflorida.com/sunbiz/other-services/subpoenas-and-public-records-exemption-requests/ 5Bond of Notary Public A bond is required by the state to be payable to any individual who may be harmed as a result of a breach of duty by said applicating acting in his/her official capacity as Notary Public, in the amount of Seven Thousand, Five Hundred Dollars ($7,500) as assurance for the due discharge of the duties of his/her office of Notary Public and we do bind ourselves, and each of our heirs, executors and administrators, jointly and severally. Applicant was, on the date of issuance of commission, bonded as a Notary Public in and for the State of Florida, to hold office for the term of four years in accordance with the Constitution and Laws of this State. Now, therefore, if said applicant shall faithfully discharge the duties of the office of Notary Public, as prescribed by law, then this obligation shall be void. I understand and agree.