Fill - Free fillable Budget Florida Ron Packet BD 25 PDF form

Why pay more when you can get everything you need to renew your

commission with remote online notary bond fast and for one low

price? Budget Notary Services offers you a high quality, four-year

Notary Package for only $168 plus tax, shipping and handling. This

includes your required $25,000 online bond, $25,000 Errors &

Omissions policy, state filing fees and a self-inking stamp guaranteed

for the entire term of your commission.

Apply for or renew your commission in 4 easy steps:

Step 1: Complete the enclosed Notary Public Commission Application and Remote Online

Notary Bond, including the state-required Driver’s License and Social Security numbers.

These may be used by the state for a background check.

Step 2: Complete the order form (on reverse).

Step 3: Return the above with your payment to Budget Notary Services.

Step 4: If you’re a first-time Notary, take the required notary education course, which you’ll find

on our website: www.BudgetNotaryInsurance.com. Print, sign and return the

completion certificate to receive your commission. This course is for first-time notary

applicants and does not meet the remote online education requirement.

Budget Notary is a state approved, reliable notary bonding agency focused on personal service.

Applications are hand delivered to the Secretary of State's office. For high quality and low cost – use

Budget Notary Services!

P.O. Box 5797 h Tallahassee, FL h 32314-5797 h

“Serving ALL Your Notary Needs”

Apply or Renew Online

www.BudgetNotaryInsurance.com

Toll Free Number: 877.298.8274

In Tallahassee: 850.219.8137

BD-25 (02/20)

Plus tax, shipping & handling

168

Traditional & Remote

Online

Notary Package Only

Because we are located in Tallahassee,

we maintain a close working

relationship with the Secretary of State’s

office to provide YOU faster service!

Click: www.BudgetNotaryInsurance.com h Call: 877.298.8274 h Follow Us:

Subtotal

Shipping & Handling

TOTAL

ORDERING OPTIONS

Description Price

Add Tax

†

Cost

Traditional & Remote Online Notary Package

(Includes Self-Inking Notary Seal - Don’t forget to select

your stamp color)

$168.00 $1.05

Customize Your Package

$25,000 Remote Online Notary Bond, $25,000 Errors &

Omissions Policy and State Filing Fees (Select notary stamp

and additional supplies below)

$154.00 n/a

ADDITIONAL SUPPLIES

Notary Public Record Book $8.00 $0.60

Self-Inking Notary Seal (Extra for home or office - select

stamp color)

$14.00 $1.05

Travel Stamp (Select stamp color) $25.50 $1.91

Florida Notary Handbook $12.75 $0.96

Embossing Seal (Additional colors available online) $28.50 $2.14

Self-Inking Round Notary Stamp (Select stamp color) $25.00 $1.88

Personalized Display Sign $15.00 $1.13

Marriage Kit $28.00 $2.10

Notary Education Course (Required for first time applicants) $22.00 n/a

For Additional Application Forms and

Notary Supplies Visit Us at

www.BudgetNotaryInsurance.com

†

No sales tax on State Fees, Bond, E&O Policies or education course.

Notary Bonds and Notary Errors & Omissions policies are underwritten by

Western Surety Company and Continental Insurance Company.

If we cannot process your order within 12 months due to lack of

information, we are no longer obligated to fulfill your order and

payment becomes non-refundable.

✔ State Filing Fees

✔ $25,000 Remote Online Notary Bond

✔ $25,000 Errors & Omissions Policy

✔ Self-Inking Notary Seal

Choice of case color

✔ Live Customer Service

$6.00

Traditional & Remote Online

Notary Package Includes . . .

NOTARY EDUCATION COURSE

Required for first time applicants (Recommended for renewing notaries)

Budget Notary’s state-approved online Notary Education Course

satisfies the requirement for first-time notaries. It’s also valuable for

renewing notaries, but not required.

We offer two options for payment. Take the course immediately and

submit the $22 payment online using our website at:

www.BudgetNotaryInsurance.com. Or, include the fee with this

order form and we’ll send you a confirmation link.

No test is required, but first-time notaries must print, sign and

return the course completion certificate to be commissioned. This

course does not meet the remote online education requirement.

168

h h h h h h h h

Only h h h h

h PRODUCTS AND ORDER INFORMATION h

SELF-INKING

NOTARY SEAL

TRAVEL STAMP

FLORIDA NOTARY

HANDBOOK

NOTARY PUBLIC

RECORD BOOK

EMBOSSING SEAL

This handheld model embosser

is small enough to easily travel

with you, while still leaving a

clear, raised lasting impression.

Additional colors available online.

This new compact stamp is

perfect if you are always on

the go.

Everything you need to know

about being a Florida notary.

This easy to understand

manual helps you notarize

lawfully and confidently.

With room for 256 entries,

and the basic guidelines for

performing a notarization, this

is a must have product.

Blue Charcoal

Silver Green

Red (Default) Fuchsia

Orange Yellow

SELF-INKING ROUND

NOTARY STAMP

This easy to use stamp meets

all notary law provisions, and

doesn’t require a separate ink

pad. Includes a cap for easy

mess free carrying.

This easy to use stamp doesn’t

require a separate stamp pad.

Purple Fuchsia

Black Green

White Grey

Blue Red (Default)

Plus tax, shipping & handling

Black

Blue

Red (Default)

PAYMENT OPTIONS

❏ CHECK OR MONEY ORDER ENCLOSED (made payable to BUDGET NOTARY SERVICES)

❏❏❏❏

CARDHOLDER NAME:

UMBER: EXPIRES:

BILLING ADDRESS:

SIGNATURE OF CARDHOLDER:

MAIL ADDRESS:

DAYTIME PHONE NUMBER: EXT:

( )

For Notary Law Updates, Product Information & Order Status Updates

P-506

NOTARY PUBLIC COMMISSION APPLICATION

Florida Department of State

Notary Commissions and Certifications Section (850) 245-6975

PERSONAL INFORMATION

Full Legal Name:

Home Address:

Place of Employment: Unemployed Retired

Business Address:

Mail to: Home Business Other Address:

E-Mail Address:

Home Phone: ( )

Business Phone: ( ) Extension

Florida Driver's License (

or other State of Florida Issued ID): Date of Birth:

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.

1. Are you a legal resident of Florida? Yes No (If No, you are not eligible to apply for a notary commission. Legal residency must be maintained throughout the

appointment.)

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. Fla. Stat. §668.50 (11)(b).) Go to www.BudgetNotaryInsurance.com to complete the notary course.

If Yes:

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.)

Have any been revoked? Yes No (If Yes, you must submit a written statement about the nature of the action and a copy of the Final Order from the regulating agency.)

6. Have you been disciplined by a regulatory 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

AFFIDAVIT OF CHARACTER

STATE OF County

I, am unrelated to and have known

for one year or more; and to the best of my knowledge and observation know him or her to be of good character.

My address is .

UNDER PENALTY OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING AFFIDAVIT AND THAT THE FACTS STATED IN IT ARE TRUE.

Home Phone: ( ) Work Phone:( ) ✔✔

(Last) (First) (Middle)

(Street) (City) (State) (County) (Zip)

(Street/P.O. Box) (City) (State) (Zip)

(or write “NONE”)

(Month/Day/Year)

(Street) (City) (State) (County) (Zip)

(or write “NONE”) (or write “NONE”) (Signature of Affiant)

(Name of Applicant)

(Print or Type Name of Affiant)

(Commission expiration date) (Commission number) (Name in which your commission was issued)

Sex: Male Race: Asian

Female Black or African American

Native American or Alaska Native

White

Other:

PO Box 5797

Tallahassee, FL 32314-5797

877.298.8274

BD-01

Mail Applications to:

APPLICANT PLEASE SIGN BACK

P-506

OATH OF OFFICE

STATE OF FLORIDA County

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.

✔

‘

MEMORANDUM

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 SOCIAL SECURITY NUMBERS, PAST AND PRESENT LAW ENFORCEMENT OFFICERS AND

THEIR FAMILIES, VICTIMS OF CERTAIN CRIMES, ETC. IF YOU BELIEVE AN EXEMPTION FROM THE PUBLIC RECORDS LAW APPLIES TO

YOUR FLORIDA NOTARY PUBLIC COMMISSION APPLICATION SUBMISSION, PLEASE CHECK THE FOLLOWING BOX:

Yes, I assert that identifying information provided in this application (other than my social security number, which I am aware is automatically

exempt from public disclosure, pursuant to Fla. Stat. §119.071) should be excluded from inspection under Public Records Law.

If Yes, please indicate what section of Florida Statues provides this exemption. If you are unsure of the Florida Statute, use the link

below to download and complete the Public Records Exemption Request forms:

https://dos.myflorida.com/media/695951/dos119.pdf

The DOS Public Records Exemption Request forms are to act as a guide to assist applicants and does not have to be submitted if

the “Yes” box is not checked.

(Official Signature of Applicant)

(Print or Type Name - name for which your commission will be issued.) Must use legal first name, no initial.

Acceptable Options: Jonathan David Doe, Jon D. Doe, Jonathan Doe, Jonathan D. Doe

(Date) MM-DD-YYYY

*Note: If you affirm, you may omit the words

“So help me God.” Fla. Stat. §92.52.

★

STATE OF FLORIDA BOND OF

NOTARY PUBLIC OR

ONLINE NOTARY PUBLIC

Secretary of State

Online Notary Commissions

Form: DOC IN-7, R. 1N-7.001, F.A.C, effective 01/2020

STATE OF FLORIDA

KNOW ALL MEN BY THESE PRESENTS, That we,

__________________________________________________________________________________ as Principal, and

__________________________________________________________ as Surety Company, give bond payable to any

individual who may be harmed as a result of a breach of duty by said applicant acting in his/her official capacity as a

Notary Public OR Online Notary Public in the amount of Twenty-Five Thousand Dollars ($25,000) as assurance for the

due discharge of the duties of his/her office of Notary Public OR Online Notary Public and we do bind ourselves, and each

of our heirs, executors and administrators, jointly and severally. Liability under this bond is limited to $7500 for acts per-

formed in the capacity of a Notary Public pursuant to section 117.01(7)(a), Florida Statutes.

Applicant was, on the date of issuance of Notary Public commission, bonded in and for the State of Florida as a Notary

Public of Florida, to hold office for the term of four years inaccordance with the Constitution and Laws of this State.

Now, therefore, if said applicant shall faithfully discharge the duties of the office of a Notary Public or Online Notary Public,

as prescribed by law, then this obligation shall be void.

✔ __________________________________________

Signed and sealed this ______________ day of ___________________________________, ____________.

_______________________________________________

By ____________________________________________

_______________________________________________

FOR OFFICE USE ONLY

Approved by Department of State:

Western Surety Company (800) 331-6053

Western Surety Company

BUDGET NOTARY SERVICES

A068326

Jack Diestelhorst

(Name of Surety Company)

(Signature of Registrant)

(Address of Surety Company)

(Name of Bonding Agency or Company)

(Address of Bonding Agency or Company)

(Signature of Florida Licensed Agent)

(Florida Licensed Agent Number)

(Printed Name of Florida Licensed Agent)

P. O. BOX 5077, Sioux Falls, SD 57117-5077

P. O. Box 5797, Tallahassee, FL 32314-5797

Imprint Name of Surety Company

(Name of Registrant)

Section 817.234(1)(b), F.S. "Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of

claim or an application containing any false, incomplete, or misleading information is guilty of a felony in the third degree."

This bond shall be for Twenty-Five Thousand Dollars ($25,000).

After execution by surety company, the bond must be submitted to the Department of State for approval

and filing before issuance of the registration of online notary public.

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