Fillable NC Notary Public Change of Status A. Notary (State of Kansas)

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NC Notary Public Change of Status A. Notary (State of Kansas)

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The NC Notary Public Change of Status A. Notary (State of Kansas) form is 1 page long and contains:

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Country of origin: US
File type: PDF

U.S.A. forms for State of Kansas

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1 / 1 Rev. 9/9/19 tc
Instructions: Complete the Name and Bond Number elds and proceed to section B.
A. Notary Information
Name (Print name under which your appointment is currently listed) Bond number (Number listed on the appointment certicate)
B. Corrected Information
Instructions: Complete the elds that need to be changed. Fields left blank are presumed unchanged. Sign and date at
the bottom of the form.
1. Stamp change
(If requesting a name change,
complete elds 1 & 2.)
(Seal/Stamp)
2. Name change
3. Residential street address
(P.O. box is not acceptable.)
Residential Street Address
City State Zip
4. Mailing address
Mailing Address
City State Zip
5. Daytime phone
6. Secondary phone
7. Miscellaneous
o
Check if you are canceling your bond.
o
Check if you need a new certicate sent.
I declare under penalty of perjury pursuant to the laws of the state of Kansas that the foregoing is true and correct.
Signature of Notary Month Day Year
kansas secretary of state
Notary Public
Change of Status
Memorial Hall, 1st Floor (785) 296-4564
120 S.W. 10th Avenue Fax: (785) 296-4570
Topeka, KS 66612-1594 notary@ks.gov
https://sos.kansas.gov
NC
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NC Notary Public Change of Status A. Notary (State of Kansas)

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Completed 27 January 2021

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