Fillable Deed Fraud Notarization

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Deed Fraud Notarization

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Page 1 of 4
DEED FRAUD / NOTARIZATION COMPLAINT FORM
The Department has authority to investigate complaints of violations of the NC Notary Public Act by notaries or others.
Instructions: Your answers should be detailed and complete. If you do not know the answer to a question or it does not apply – say
so. If you need more space, add pages and title them with the question they answer. You must attach documents to your complaint if
they are related and may be useful when we review the complaint. Examples of documents to attach are: the document(s) your
complaint is about; letters or correspondence between you and the person or business your complaint is about; related documents
regarding lawsuits or foreclosures. If you are unsure, include the document. Please type or print clearly.
INFORMATION ABOUT YOU
FULL NAME:
AGE:
First Middle Last
ADDRESS:
CITY:
STATE:
ZIP
:
PREFERRED
PHONE:
BUSINESS PHONE:
OTHER
PHONE:
E-MAIL:
INFORMATION ABOUT THE PROPERTY
ADDRESS OF
PROPERTY:
CITY: STATE:
ZIP:
COUNTY:
Describe the property
STATE OF NORTH CAROLINA
DEPARTMENT OF THE SECRETARY OF STATE
___________________________________________________________
Office of Notary Investigations and Enforcement
PHONE: 919-814-5400 E-MAIL: Notary@sosnc.gov
WEBSITE ADDRESS: WWW.SOSNC.GOV
Page 2 of 4
Does this complaint involve a person acting as a notary? _____ _________ If no, go to question # 7
PEOPLE WHO MAY HAVE INFORMATION RELATED TO THIS COMPLAINT
Service Providers
Company’s Address
Contact Person
Phone Number
Your Attorney
Closing Attorney
Real Estate Agent/Broker
Title Company
Loan Officer
Other
WHO IS THIS COMPLAINT ABOUT?
Name
Title/Position
Address
Phone No.
Are you related to any of the people you are complaining about? _____ _________
NAME OF NOTARY’S
EMPLOYER:
OTHER NAMES
THE EMPLOYER
USES:
ADDRESS OF Employer
CITY:
STATE:
ZIP
:
PHONE:
CELL PHONE:
E-MAIL:
1. What is your complaint? Be specific.
Page 3 of 4
2. List documents in your possession that relate to your complaint. Attach copies to this complaint.
3. Have you contacted any other governmental agency regarding your complaint? If so, provide this information:
Agency Address Telephone Contact Person
4. Have you contacted the person or organization against which you have a complaint? If so, provide the name of the person
you spoke with and what their response was. (Attach copies of documents exchanged.)
5. Have you been contacted by an attorney regarding this matter on behalf of another? If yes, provide this information:
Attorney Name Address Telephone
6. Is either a lawsuit or a foreclosure claim pending? If so, provide the name and location of the court as well as the name,
title, and index number of the proceeding. (Provide copies of any relevant court documents.)
Page 4 of 4
7. Are you aware of any person other than yourself that might have had a similar experience who might be able to provide
additional information that would be helpful?
Name Address Telephone
8. Are you aware of any other people, principals, associates or organizations affiliated with the subject of your complaint that
might be able to provide additional details regarding this matter? If so, provide:
Name of Person or
Organization
Address
Telephone
Contact Person for Organization
By signing this complaint you acknowledge that you are willing to appear in court and testify in this matter if necessary.
Mail the completed form and attachments to: NC Department of the Secretary of State, Notary Enforcement
Section, P.O. Box 29626, Raleigh, NC 27626-0622
Signature
Printed Name
NOTICE: The NC Department’s Notary Enforcement Section investigates possible official misconduct by notaries and others who
allegedly commit Notary Act violations. The Department does not act as your attorney or help you with other real estate-related issues.
The Department is not responsible for recovering your property or money. If you have questions about your legal rights and
responsibilities, consult your own attorney. There is information about other possible resources on our
website.
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Deed Fraud Notarization

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Completed 3 July 2020

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