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NEBRASKA SECRETARY OF STATE (Nebraska)

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NEBRASKA SECRETARY OF STATE
Business Services Division: Notary
1201 N Street, Suite 120, Lincoln, NE 68508
P. O. Box 95104, Lincoln, NE 68509
www.sos.nebraska.gov
Revised 6/15/2021
NOTARY PUBLIC RENEWAL APPLICATION
This application is only accepted within the 30 days immediately preceding your current commission expiration date.
APPLICANT INFORMATION
Print your legal name as it appears on your driver’s license, state identification card, or voter’s registration (if no driver’s license).
We suggest your legal name, signature, and seal all match.
Last Name
First Name
MI
Date
Home Address
Street Address
Suite/Unit #
PO Box (if any)
City
State
E-mail Address
Phone Number
Business Address (Required for non-resident applicant.)
Check here if you work from home (see instructions)
Company Name
Street Address
Suite/Unit #
PO Box (if any)
City
State
E-mail Address
Work Phone Number
Return Commission Certificate(s) to:
Home Address
Business Address
Email Address at:
Non-resident applicants must also submit an Evidence of Employment in Nebraska form.
NOTARY PUBLIC QUALIFICATIONS IN THE STATE OF NEBRASKA (All questions must be answered) *Not Applicable
1. Have you been convicted of a felony?
YES
NO
4. If you are bilingual, would you allow
your name to be placed on a list of
bilingual notaries?
*NA
YES
NO
2. Have you been convicted of a crime
involving fraud or dishonesty?
YES
NO
4a. List languages in which you are fluent:
2a. If yes, please detail conviction, the state and the date of the crime.
(Attach additional pages if needed.)
Affix impression of your seal below:
3. Has your name changed since your
previous commission?
YES
NO
3a. If yes, please list previous name.
ELECTRONIC NOTARY PUBLIC RENEWAL
5. If you’re an electronic notary public in the State of Nebraska do you want to renew the registration?
*NA
YES
NO
6. If you answered yes to #5, which solution provider do you intend to use for electronic notarization?
ONLINE NOTARY PUBLIC RENEWAL
7. If you’re an online notary public in the State of Nebraska do you want to renew the registration?
*NA
YES
NO
8. If you answered yes to #7, which solution provider do you intent to use for online notarizations?
NOTARIAL OATH
Your signature below will be used to verify signature authenticity when performing notarial acts.
You must sign consistently.
State of County of
I, , do solemnly (swear), (affirm) under penalty of perjury, that the answers to all questions
on this application are true and complete to the best of my knowledge; and, I do solemnly (swear) (affirm) that upon appointment, I will support the
Constitution and laws of the United States and the State of Nebraska, and I will faithfully discharge the duties of Notary Public, Electronic Notary
Public, and/or Online Notary Public in and for the State of Nebraska according to the best of my ability.
X
Applicant’s Signature
Subscribed and (sworn) (affirmed) before me: this day of , 20 .
(Month) (Year)
Signature of Notary Public
^Affix Official Notary Seal^
Revised 06/15/2021
NEBRASKA SECRETARY OF STATE
Business Services Division: Notary
1201 N Street, Suite 120, Lincoln, NE 68508
P. O. Box 95104, Lincoln, NE 68509
www.sos.nebraska.gov
NOTARY RENEWAL APPLICATION
APPLICANT INFORMATION:
Name: Enter your legal name for our records. Print name as listed on your state issued driver’s license, identification card, or voter
registration name (if no driver’s license).
Date:
Enter the date you are completing the application.
Home Address: You are required to enter your home street address, a P.O. box alone is not sufficient. An email address is mandatory for all
electronic notaries public and online notaries public.
Business Address: If you are a non-resident applicant, your business address is required and you must complete this section in its entirety.
If you are a Nebraska resident, this section is optional, but if provided, this information may be used to contact you if needed. Your home
address and business address can only be the same if you are a Nebraska resident working from home and you check the corresponding
box, if not your application may be rejected or returned.
Indicate where you would like your certificate(s) returned by checking the appropriate box. If email is selected, provide the email address
where the certificate(s) should be sent.
Please note that email addresses submitted on this application becomes part of the public record.
NOTARY PUBLIC QUALIFICATIONS IN THE STATE OF NEBRASKA:
All questions in this section must be answered. Read each question carefully and clearly mark the appropriate box or fill in the
details to answer questions. Failure to answer all questions may result in your application being rejected or returned.
ELECTRONIC NOTARY PUBLIC RENEWAL:
If you’ve previously been registered as an electronic notary, complete questions 6 and 7 in this section in order to renew your electronic
notary registration. Read each question carefully and clearly mark the appropriate box or fill in the details to answer the question.
You are not authorized to perform electronic notarial acts (enotarizations) until all requirements are completed and you have received your
Electronic Notary Certificate of Registration.
ONLINE NOTARY PUBLIC RENEWAL:
If you’ve previously been registered as an online notary public, complete questions 8 and 9 in this section in order to renew your online
notary registration. Read each question carefully and clearly mark the appropriate box or fill in the details to answer the question.
You are not authorized to perform online notarial acts until all requirements are completed and you have received your Online Notary
Certificate of Registration.
NOTARIAL OATH:
The signature you place on this application is the signature that you must use when notarizing documents. You must sign consistently. Your
signature on the application will be used to verify your signature on additional forms in the filing process, if a complaint is ever filed against
you, or if a document you notarize must be certified for use in another country. Your commission certificate and seal will be issued to match
your signature as signed on this application.
REQUIREMENTS:
Applicant must submit the following: Notary Renewal Application, $15,000 surety bond, U.S. Citizenship Attestation Form, Evidence of
Employment in Nebraska Form (Non-residents Only) and the $30 fee. If the applicant is also renewing their electronic notary
registration they must pay the $100 electronic notary fee in addition to the $30 notary public fee. If the applicant is also renewing their
online notary registration they must pay the $50 online notary fee in addition to the notary public fee and electronic notary registration fee if
renewing that as well. All fees must be made to the Nebraska Secretary of State.
If you have any questions when completing the application please check our website at:
https://sos.nebraska.gov/business-services/notary-
public, email sos.notary@nebraska.gov or
call (402) 471-2558.
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NEBRASKA SECRETARY OF STATE (Nebraska)

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Completed 7 March 2022

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