NORTH CAROLINA DEPARTMENT OF THE SECRETARY OF STATE
PO BOX 29626, RALEIGH, NC 27626-0626
919-814-4500
NOTARY@SOSNC.COM
WWW.SOSNC.GOV 1/2019
CERTIFICATE OF MORAL CHARACTER FOR:
Applicant for Notary Public
Section A
1- I am aware of the charges/convictions against this Notary applicant. Yes No
2- Will the charges/convictions against this applicant affect his/her ability to act as a Notary. Yes
No
3- How long and well have you known the applicant? (This form is to be completed by someone other than a family member
that has known the applicant for at least 2 years. Please include the nature of your relationship.)_______________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
4- What opportunities have you had for forming an opinion of this applicant’s character? ____________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
5- Are you personally acquainted with the applicant’s associates? _____________ If so, what is their reputation in the community?
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
6- What is the applicant’s reputation for honesty? _______________________________ Integrity? ___________________________
Trustworthiness? ___________________________________ Character? ________________________________________________
Section B
Please indicate to the best of your knowledge whether or not the applicant has ever been:
7- Dropped, suspended, asked to resign or subjected to other discipline from an educational institution Yes No
8- Discharged or asked to resign from employment Yes
No
9- Addicted to the use of drugs (illegal or legal) or intoxicating liquors Yes
No
10- Regularly treated for any form of mental disability Yes
No
If the answer to any of the above is yes, please explain in detail on a separate page.
Section C
Please indicate your honest opinion:
11- Would you recommend this applicant for a position of trust and confidence? Yes
No
12- Does this applicant possess the high standards of moral character you would expect from a notary? Yes
No
If the answer to either of these two questions is no, please explain in detail on a separate page.
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I hereby certify that the information given in the foregoing answers is correct and was given from personal knowledge, and
I further certify that any information received from others has been obtained from sources from which I believe to be reliable
and was not secured from the applicant or members of the applicant’s family.
I p
ersonally recommend __________________________________________________ to become a Notary Public.
(printed name of Applicant)
Name of Character Witness: __________________________________________________
Signature of Character Witness: _________________________________________________
Address: __________________________________ Employer: __________________________________
__________________________________ Home/Cell Phone: __________________________________
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State of North Carolina
County: _________________________
Signed and sworn to before me this the _____ day of ___________________, ________ by ___________________________.
(printed name of Character Witness)
________________________________
(Official Signature of Notary Public) (seal)
My Commission Expires: ___________________________, 20____.
CERTIFICATE OF MORAL CHARACTER
