Fillable ORDER FORM for EXISTING NOTARIES (Stegall Notary Service)

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ORDER FORM for EXISTING NOTARIES (Stegall Notary Service)

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INDIVI DUAL ITEM DESCRIPTION UNIT PRICE QTY. TOTAL
SUBTOTAL
Shipping
& Handling
TOTAL REMITTANCE
3 . State-Require d, Self-Inking Seal Sta mp
(see left)
Show s Name, County, Expiration Dat e and Notary I. D. #
4. “Mississippi” Notary Official Record Book
. kooba h t i ws l awet f o r r e non t ubi e s , r a t oNw enr o fd e r i uqeR
5. Notary Public Errors
&
Omissions Insurance
a. $10,000 4-year Policy
b. $15,000 4-year Policy
6. Notary Public Desk Plate
a. Regular
b. Personalized
7. Jurat Stamp
8. Stamp Ink, 1 oz, indicate color_____________
a. Rubber Stamp
b. Self-Inking Stamp
1 . Notary Public Statewide Commission
(4-year)
2. Notar y Public Bond (
$
5000, 4-year Surety)
(Include s
$
10,00 0 E rrors
&
Omission s Insurance)
ORD ER FORM for New or Renewal Commissions
EMAIL
: stegall@bellsouth.net
WEB
: www.StegallNotaryService.com
PHYSICA L ADDRESS
:
14 Northtown Drive
Jackson, MS 39211
MAILING ADDRESS
:
P.O. Box 12913
Jackson, MS 39236
PHONE
:
800.303.9505
601.957.9505
OWNERS
: J. Earl Stegall
& Maxine W. Stegall,
Licensed Insurance Agents
PLEASE FOLLOW THESE 3 STEPS: Note: Incomplete for ms will be returned.
POSTAL SHIPPING TO: PLEASE PRINT CLEARLY. (We ship via U.S. Postal Service)
Name: ______________________________________________________ MS Driver’s License No. _________________________
Name of Business at Mailing Address
(if any): ______________________________________ Bus./Daytime Phone: ___________________
Mailing Address:_________________________________________________________________________________________
City:_____________________________________________ State:_______________________ Zip: ___________________
Complete Notary Application AND have signature NOTARIZED.
Sign “Principal” line at the “X”, and
Sign the Oath of Office at the “X”, and have NOTARIZED.
DO NOT COMPLETE the TOP PORTION of the BOND.
Mark all Items or Kit you wish to order below.
Make check payable to STEGALL NOTARY SERVICE.
Return Order Form, Application, Bond and Check to: P.O. Box 12913, Jackson, MS 39236
YOU COMPLETE 2 STEPS ABOVE, WE WILL HANDLE THE REST.
We will obtain your Notary Commission, file your Bond with the Secretaryof State and send all your notary supplies to you promptly.
1
2
REQUIRED
$
10,000
Errors & Omissions
Insurance Policy
FREE
with each
Bond Order!
$
$
$
STATE REGULATION:
Effective July 1, 2007, the Secretary o f State is requiring
all NEW
& RENEWING Notaries to use a Self-Inking
Seal Stamp containing Name, Residence County,
Expiration Date and State issued ID Number.
Visit our website for pictures & descriptions
www.StegallNotaryService.com
Beautiful navy blue faux-leather
cover with gold embossed lettering.
Offered exclusively
by Stegall Notary Service.
A Stegall Notary
Service Exclusive!
MISSISSIPPI
OWNED & OPERATED
MISSISSIPPI
OWNED & OPERATED
Required by Law
MISSISSIPPI
Notary Public Official Record Book
OWNER: Cooper D. Allen
Licensed Insurance Agent
INDIVI DUAL ITEM DESCRIPTION UNIT PRICE QTY. TOTAL
SUBTOTAL
Shipping
& Handling
TOTAL REMITTANCE
3 . State-Require d, Self-Inking Seal Sta mp
(see left)
Show s Name, County, Expiration Dat e and Notary I. D. #
4. “Mississippi” Notary Official Record Book
. kooba h t i ws l awet f o r r e non t ubi e s , r a t oNw enr o fd e r i uqeR
5. Notary Public Errors
&
Omissions Insurance
a. $10,000 4-year Policy
b. $15,000 4-year Policy
6. Notary Public Desk Plate
a. Regular
b. Personalized
7. Jurat Stamp
8. Stamp Ink, 1 oz, indicate color_____________
a. Rubber Stamp
b. Self-Inking Stamp
1 . Notary Public Statewide Commission
(4-year)
2. Notar y Public Bond (
$
5000, 4-year Surety)
(Include s
$
10,00 0 E rrors
&
Omission s Insurance)
ORD ER FORM for New or Renewal Commissions
EMAIL
: stegall@bellsouth.net
WEB
: www.StegallNotaryService.com
PHYSICA L ADDRESS
:
14 Northtown Drive
Jackson, MS 39211
MAILING ADDRESS
:
P.O. Box 12913
Jackson, MS 39236
PHONE
:
800.303.9505
601.957.9505
OWNERS
: J. Earl Stegall
& Maxine W. Stegall,
Licensed Insurance Agents
PLEASE FOLLOW THESE 3 STEPS: Note: Incomplete for ms will be returned.
POSTAL SHIPPING TO: PLEASE PRINT CLEARLY. (We ship via U.S. Postal Service)
Name: ______________________________________________________ MS Driver’s License No. _________________________
Name of Business at Mailing Address
(if any): ______________________________________ Bus./Daytime Phone: ___________________
Mailing Address:_________________________________________________________________________________________
City:_____________________________________________ State:_______________________ Zip: ___________________
Complete Notary Application AND have signature NOTARIZED.
Sign “Principal” line at the “X”, and
Sign the Oath of Office at the “X”, and have NOTARIZED.
DO NOT COMPLETE the TOP PORTION of the BOND.
Mark all Items or Kit you wish to order below.
Make check payable to STEGALL NOTARY SERVICE.
Return Order Form, Application, Bond and Check to: P.O. Box 12913, Jackson, MS 39236
YOU COMPLETE 2 STEPS ABOVE, WE WILL HANDLE THE REST.
We will obtain your Notary Commission, file your Bond with the Secretaryof State and send all your notary supplies to you promptly.
1
2
REQUIRED
$
10,000
Errors & Omissions
Insurance Policy
FREE
with each
Bond Order!
$
$
$
STATE REGULATION:
Effective July 1, 2007, the Secretary o f State is requiring
all NEW
& RENEWING Notaries to use a Self-Inking
Seal Stamp containing Name, Residence County,
Expiration Date and State issued ID Number.
Visit our website for pictures & descriptions
www.StegallNotaryService.com
Beautiful navy blue faux-leather
cover with gold embossed lettering.
Offered exclusively
by Stegall Notary Service.
A Stegall Notary
Service Exclusive!
MISSISSIPPI
OWNED & OPERATED
MISSISSIPPI
OWNED & OPERATED
Required by Law
MISSISSIPPI
Notary Public Official Record Book
INDIVI DUAL ITEM DESCRIPTION UNIT PRICE QTY. TOTAL
SUBTOTAL
Shipping
& Handling
TOTAL REMITTANCE
3 . State-Require d, Self-Inking Seal Sta mp
(see left)
Show s Name, County, Expiration Dat e and Notary I. D. #
4. “Mississippi” Notary Official Record Book
. kooba h t i ws l awet f o r r e non t ubi e s , r a t oNw enr o fd e r i uqeR
5. Notary Public Errors
&
Omissions Insurance
a. $10,000 4-year Policy
b. $15,000 4-year Policy
6. Notary Public Desk Plate
a. Regular
b. Personalized
7. Jurat Stamp
8. Stamp Ink, 1 oz, indicate color_____________
a. Rubber Stamp
b. Self-Inking Stamp
1 . Notary Public Statewide Commission
(4-year)
2. Notar y Public Bond (
$
5000, 4-year Surety)
(Include s
$
10,00 0 E rrors
&
Omission s Insurance)
ORD ER FORM for New or Renewal Commissions
EMAIL
: stegall@bellsouth.net
WEB
: www.StegallNotaryService.com
PHYSICA L ADDRESS
:
14 Northtown Drive
Jackson, MS 39211
MAILING ADDRESS
:
P.O. Box 12913
Jackson, MS 39236
PHYSICAL ADDRESS:
14 Northtown Drive
Jackson, MS 39211
MAILING ADDRESS:
P.O. Box 12913
Jackson, MS 39236
PHONE:
8 44.303.9505
601.957.9505
OWNERS
: J. Earl Stegall
& Maxine W. Stegall,
Licensed Insurance Agents
PLEASE FOLLOW THESE 3 STEPS: Note: Incomplete for ms will be returned.
POSTAL SHIPPING TO: PLEASE PRINT CLEARLY. (We ship via U.S. Postal Service)
Name: ______________________________________________________ MS Driver’s License No. _________________________
Name of Business at Mailing Address
(if any): ______________________________________ Bus./Daytime Phone: ___________________
Mailing Address:_________________________________________________________________________________________
City:_____________________________________________ State:_______________________ Zip: ___________________
Complete Notary Application AND have signature NOTARIZED.
Sign “Principal” line at the “X”, and
Sign the Oath of Office at the “X”, and have NOTARIZED.
DO NOT COMPLETE the TOP PORTION of the BOND.
Mark all Items or Kit you wish to order below.
Make check payable to STEGALL NOTARY SERVICE.
Return Order Form, Application, Bond and Check to: P.O. Box 12913, Jackson, MS 39236
YOU COMPLETE 2 STEPS ABOVE, WE WILL HANDLE THE REST.
We will obtain your Notary Commission, file your Bond with the Secretaryof State and send all your notary supplies to you promptly.
1
2
REQUIRED
$
10,000
Errors & Omissions
Insurance Policy
FREE
with each
Bond Order!
$
$
$
STATE REGULATION:
Effective July 1, 2007, the Secretary o f State is requiring
all NEW
& RENEWING Notaries to use a Self-Inking
Seal Stamp containing Name, Residence County,
Expiration Date and State issued ID Number.
Visit our website for pictures & descriptions
www.StegallNotaryService.com
Beautiful navy blue faux-leather
cover with gold embossed lettering.
Offered exclusively
by Stegall Notary Service.
A Stegall Notary
Service Exclusive!
MISSISSIPPI
OWNED & OPERATED
MISSISSIPPI
OWNED & OPERATED
Required by Law
MISSISSIPPI
Notary Public Official Record Book
INDIVI DUAL ITEM DESCRIPTION UNIT PRICE QTY. TOTAL
SUBTOTAL
Shipping
& Handling
TOTAL REMITTANCE
3 . State-Require d, Self-Inking Seal Sta mp
(see left)
Show s Name, County, Expiration Dat e and Notary I. D. #
4. “Mississippi” Notary Official Record Book
. kooba h t i ws l awet f o r r e non t ubi e s , r a t oNw enr o fd e r i uqeR
5. Notary Public Errors
&
Omissions Insurance
a. $10,000 4-year Policy
b. $15,000 4-year Policy
6. Notary Public Desk Plate
a. Regular
b. Personalized
7. Jurat Stamp
8. Stamp Ink, 1 oz, indicate color_____________
a. Rubber Stamp
b. Self-Inking Stamp
1 . Notary Public Statewide Commission
(4-year)
2. Notar y Public Bond (
$
5000, 4-year Surety)
(Include s
$
10,00 0 E rrors
&
Omission s Insurance)
ORD ER FORM for New or Renewal Commissions
EMAIL
: stegall@bellsouth.net
WEB
: www.StegallNotaryService.com
PHYSICA L ADDRESS
:
14 Northtown Drive
Jackson, MS 39211
MAILING ADDRESS
:
P.O. Box 12913
Jackson, MS 39236
PHONE
:
800.303.9505
601.957.9505
OWNERS
: J. Earl Stegall
& Maxine W. Stegall,
Licensed Insurance Agents
PLEASE FOLLOW THESE 3 STEPS: Note: Incomplete for ms will be returned.
POSTAL SHIPPING TO: PLEASE PRINT CLEARLY. (We ship via U.S. Postal Service)
Name: ______________________________________________________ MS Driver’s License No. _________________________
Name of Business at Mailing Address
(if any): ______________________________________ Bus./Daytime Phone: ___________________
Mailing Address:_________________________________________________________________________________________
City:_____________________________________________ State:_______________________ Zip: ___________________
Complete Notary Application AND have signature NOTARIZED.
Sign “Principal” line at the “X”, and
Sign the Oath of Office at the “X”, and have NOTARIZED.
DO NOT COMPLETE the TOP PORTION of the BOND.
Mark all Items or Kit you wish to order below.
Make check payable to STEGALL NOTARY SERVICE.
Return Order Form, Application, Bond and Check to: P.O. Box 12913, Jackson, MS 39236
YOU COMPLETE 2 STEPS ABOVE, WE WILL HANDLE THE REST.
We will obtain your Notary Commission, file your Bond with the Secretaryof State and send all your notary supplies to you promptly.
1
2
REQUIRED
$
10,000
Errors & Omissions
Insurance Policy
FREE
with each
Bond Order!
$
$
$
STATE REGULATION:
Effective July 1, 2007, the Secretary o f State is requiring
all NEW
& RENEWING Notaries to use a Self-Inking
Seal Stamp containing Name, Residence County,
Expiration Date and State issued ID Number.
Visit our website for pictures & descriptions
www.StegallNotaryService.com
Beautiful navy blue faux-leather
cover with gold embossed lettering.
Offered exclusively
by Stegall Notary Service.
A Stegall Notary
Service Exclusive!
MISSISSIPPI
OWNED & OPERATED
MISSISSIPPI
OWNED & OPERATED
Required by Law
MISSISSIPPI
Notary Public Official Record Book
INDIVI DUAL ITEM DESCRIPTION UNIT PRICE QTY. TOTAL
SUBTOTAL
Shipping
& Handling
TOTAL REMITTANCE
3 . State-Require d, Self-Inking Seal Sta mp
(see left)
Show s Name, County, Expiration Dat e and Notary I. D. #
4. “Mississippi” Notary Official Record Book
. kooba h t i ws l awet f o r r e non t ubi e s , r a t oNw enr o fd e r i uqeR
5. Notary Public Errors
&
Omissions Insurance
a. $10,000 4-year Policy
b. $15,000 4-year Policy
6. Notary Public Desk Plate
a. Regular
b. Personalized
7. Jurat Stamp
8. Stamp Ink, 1 oz, indicate color_____________
a. Rubber Stamp
b. Self-Inking Stamp
1 . Notary Public Statewide Commission
(4-year)
2. Notar y Public Bond (
$
5000, 4-year Surety)
(Include s
$
10,00 0 E rrors
&
Omission s Insurance)
ORD ER FORM for New or Renewal Commissions
EMAIL
: stegall@bellsouth.net
WEB
: www.StegallNotaryService.com
PHYSICA L ADDRESS
:
14 Northtown Drive
Jackson, MS 39211
PHONE
:
800.303.9505
601.957.9505
OWNERS
: J. Earl Stegall
& Maxine W. Stegall,
Licensed Insurance Agents
PLEASE FOLLOW THESE 3 STEPS: Note: Incomplete for ms will be returned.
POSTAL SHIPPING TO: PLEASE PRINT CLEARLY. (We ship via U.S. Postal Service)
Name: ______________________________________________________ MS Driver’s License No. _________________________
Name of Business at Mailing Address
(if any): ______________________________________ Bus./Daytime Phone: ___________________
Mailing Address:_________________________________________________________________________________________
City:_____________________________________________ State:_______________________ Zip: ___________________
Complete Notary Application AND have signature NOTARIZED.
Sign “Principal” line at the “X”, and
Sign the Oath of Office at the “X”, and have NOTARIZED.
DO NOT COMPLETE the TOP PORTION of the BOND.
Mark all Items or Kit you wish to order below.
Make check payable to STEGALL NOTARY SERVICE.
Return Order Form, Application, Bond and Check to: P.O. Box 12913, Jackson, MS 39236
YOU COMPLETE 2 STEPS ABOVE, WE WILL HANDLE THE REST.
We will obtain your Notary Commission, file your Bond with the Secretaryof State and send all your notary supplies to you promptly.
1
2
REQUIRED
$
10,000
Errors & Omissions
Insurance Policy
FREE
with each
Bond Order!
$
$
$
STATE REGULATION:
Effective July 1, 2007, the Secretary o f State is requiring
all NEW
& RENEWING Notaries to use a Self-Inking
Seal Stamp containing Name, Residence County,
Expiration Date and State issued ID Number.
Visit our website for pictures & descriptions
www.StegallNotaryService.com
Beautiful navy blue faux-leather
cover with gold embossed lettering.
Offered exclusively
by Stegall Notary Service.
A Stegall Notary
Service Exclusive!
MISSISSIPPI
OWNED & OPERATED
MISSISSIPPI
OWNED & OPERATED
Required by Law
MISSISSIPPI
Notary Public Official Record Book
INDIVI DUAL ITEM DESCRIPTION UNIT PRICE QTY. TOTAL
SUBTOTAL
Shipping
& Handling
TOTAL REMITTANCE
3 . State-Require d, Self-Inking Seal Sta mp
(see left)
Show s Name, County, Expiration Dat e and Notary I. D. #
4. “Mississippi” Notary Official Record Book
. kooba h t i ws l awet f o r r e non t ubi e s , r a t oNw enr o fd e r i uqeR
5. Notary Public Errors
&
Omissions Insurance
a. $10,000 4-year Policy
b. $15,000 4-year Policy
6. Notary Public Desk Plate
a. Regular
b. Personalized
7. Jurat Stamp
8. Stamp Ink, 1 oz, indicate color_____________
a. Rubber Stamp
b. Self-Inking Stamp
1 . Notary Public Statewide Commission
(4-year)
2. Notar y Public Bond (
$
5000, 4-year Surety)
(Include s
$
10,00 0 E rrors
&
Omission s Insurance)
ORD ER FORM for New or Renewal Commissions
EMAIL
: stegall@bellsouth.net
WEB
: www.StegallNotaryService.com
MAILING ADDRESS
:
P.O. Box 12913
Jackson, MS 39236
PHONE
:
800.303.9505
601.957.9505
OWNERS
: J. Earl Stegall
& Maxine W. Stegall,
Licensed Insurance Agents
PLEASE FOLLOW THESE 3 STEPS: Note: Incomplete for ms will be returned.
POSTAL SHIPPING TO: PLEASE PRINT CLEARLY. (We ship via U.S. Postal Service)
Name: ______________________________________________________ MS Driver’s License No. _________________________
Name of Business at Mailing Address
(if any): ______________________________________ Bus./Daytime Phone: ___________________
Mailing Address:_________________________________________________________________________________________
City:_____________________________________________ State:_______________________ Zip: ___________________
Complete Notary Application AND have signature NOTARIZED.
Sign “Principal” line at the “X”, and
Sign the Oath of Office at the “X”, and have NOTARIZED.
DO NOT COMPLETE the TOP PORTION of the BOND.
Mark all Items or Kit you wish to order below.
Make check payable to STEGALL NOTARY SERVICE.
Return Order Form, Application, Bond and Check to: P.O. Box 12913, Jackson, MS 39236
YOU COMPLETE 2 STEPS ABOVE, WE WILL HANDLE THE REST.
We will obtain your Notary Commission, file your Bond with the Secretaryof State and send all your notary supplies to you promptly.
1
2
REQUIRED
$
10,000
Errors & Omissions
Insurance Policy
FREE
with each
Bond Order!
$
$
$
STATE REGULATION:
Effective July 1, 2007, the Secretary o f State is requiring
all NEW
& RENEWING Notaries to use a Self-Inking
Seal Stamp containing Name, Residence County,
Expiration Date and State issued ID Number.
Visit our website for pictures & descriptions
www.StegallNotaryService.com
Beautiful navy blue faux-leather
cover with gold embossed lettering.
Offered exclusively
by Stegall Notary Service.
A Stegall Notary
Service Exclusive!
MISSISSIPPI
OWNED & OPERATED
MISSISSIPPI
OWNED & OPERATED
Required by Law
MISSISSIPPI
Notary Public Official Record Book
INDIVI DUAL ITEM DESCRIPTION UNIT PRICE QTY. TOTAL
SUBTOTAL
Shipping
& Handling
TOTAL REMITTANCE
3 . State-Require d, Self-Inking Seal Sta mp
(see left)
Show s Name, County, Expiration Dat e and Notary I. D. #
4. “Mississippi” Notary Official Record Book
. kooba h t i ws l awet f o r r e non t ubi e s , r a t oNw enr o fd e r i uqeR
5. Notary Public Errors
&
Omissions Insurance
a. $10,000 4-year Policy
b. $15,000 4-year Policy
6. Notary Public Desk Plate
a. Regular
b. Personalized
7. Jurat Stamp
8. Stamp Ink, 1 oz, indicate color_____________
a. Rubber Stamp
b. Self-Inking Stamp
1 . Notary Public Statewide Commission
(4-year)
2. Notar y Public Bond (
$
5000, 4-year Surety)
(Include s
$
10,00 0 E rrors
&
Omission s Insurance)
ORD ER FORM for New or Renewal Commissions
EMAIL
: stegall@bellsouth.net
WEB
: www.StegallNotaryService.com
PHYSICA L ADDRESS
:
14 Northtown Drive
Jackson, MS 39211
MAILING ADDRESS
:
P.O. Box 12913
Jackson, MS 39236
PHONE
:
800.303.9505
601.957.9505
OWNERS
: J. Earl Stegall
& Maxine W. Stegall,
Licensed Insurance Agents
PLEASE FOLLOW THESE 3 STEPS: Note: Incomplete for ms will be returned.
POSTAL SHIPPING TO: PLEASE PRINT CLEARLY. (We ship via U.S. Postal Service)
Name: ______________________________________________________ MS Driver’s License No. _________________________
Name of Business at Mailing Address
(if any): ______________________________________ Bus./Daytime Phone: ___________________
Mailing Address:_________________________________________________________________________________________
City:_____________________________________________ State:_______________________ Zip: ___________________
Complete Notary Application AND have signature NOTARIZED.
Sign “Principal” line at the “X”, and
Sign the Oath of Office at the “X”, and have NOTARIZED.
DO NOT COMPLETE the TOP PORTION of the BOND.
Mark all Items or Kit you wish to order below.
Make check payable to STEGALL NOTARY SERVICE.
Return Order Form, Application, Bond and Check to: P.O. Box 12913, Jackson, MS 39236
YOU COMPLETE 2 STEPS ABOVE, WE WILL HANDLE THE REST.
We will obtain your Notary Commission, file your Bond with the Secretaryof State and send all your notary supplies to you promptly.
1
2
REQUIRED
$
10,000
Errors & Omissions
Insurance Policy
FREE
with each
Bond Order!
$
$
$
STATE REGULATION:
Effective July 1, 2007, the Secretary o f State is requiring
all NEW
& RENEWING Notaries to use a Self-Inking
Seal Stamp containing Name, Residence County,
Expiration Date and State issued ID Number.
Visit our website for pictures & descriptions
www.StegallNotaryService.com
Beautiful navy blue faux-leather
cover with gold embossed lettering.
Offered exclusively
by Stegall Notary Service.
A Stegall Notary
Service Exclusive!
MISSISSIPPI
OWNED & OPERATED
MISSISSIPPI
OWNED & OPERATED
Required by Law
MISSISSIPPI
Notary Public Official Record Book
v 09.14
8.00
INDIVI DUAL ITEM DESCRIPTION UNIT PRICE QTY. TOTAL
SUBTOTAL
Shipping
& Handling
TOTAL REMITTANCE
3 . State-Require d, Self-Inking Seal Sta mp
(see left)
Show s Name, County, Expiration Dat e and Notary I. D. #
4. “Mississippi” Notary Official Record Book
. kooba h t i ws l awet f o r r e non t ubi e s , r a t oNw enr o fd e r i uqeR
5. Notary Public Errors
&
Omissions Insurance
a. $10,000 4-year Policy
b. $15,000 4-year Policy
6. Notary Public Desk Plate
a. Regular
b. Personalized
7. Jurat Stamp
8. Stamp Ink, 1 oz, indicate color_____________
a. Rubber Stamp
b. Self-Inking Stamp
1 . Notary Public Statewide Commission
(4-year)
2. Notar y Public Bond (
$
5000, 4-year Surety)
(Include s
$
10,00 0 E rrors
&
Omission s Insurance)
ORD ER FORM for New or Renewal Commissions
EMAIL
: stegall@bellsouth.net
WEB
: www.StegallNotaryService.com
PHYSICA L ADDRESS
:
14 Northtown Drive
Jackson, MS 39211
MAILING ADDRESS
:
P.O. Box 12913
Jackson, MS 39236
PHONE
:
800.303.9505
601.957.9505
OWNERS
: J. Earl Stegall
& Maxine W. Stegall,
Licensed Insurance Agents
PLEASE FOLLOW THESE 3 STEPS: Note: Incomplete for ms will be returned.
POSTAL SHIPPING TO: PLEASE PRINT CLEARLY. (We ship via U.S. Postal Service)
Name: ______________________________________________________ MS Driver’s License No. _________________________
Name of Business at Mailing Address
(if any): ______________________________________ Bus./Daytime Phone: ___________________
Mailing Address:_________________________________________________________________________________________
City:_____________________________________________ State:_______________________ Zip: ___________________
Complete Notary Application AND have signature NOTARIZED.
Sign “Principal” line at the “X”, and
Sign the Oath of Office at the “X”, and have NOTARIZED.
DO NOT COMPLETE the TOP PORTION of the BOND.
Mark all Items or Kit you wish to order below.
Make check payable to STEGALL NOTARY SERVICE.
Return Order Form, Application, Bond and Check to: P.O. Box 12913, Jackson, MS 39236
YOU COMPLETE 2 STEPS ABOVE, WE WILL HANDLE THE REST.
We will obtain your Notary Commission, file your Bond with the Secretaryof State and send all your notary supplies to you promptly.
1
2
REQUIRED
$
10,000
Errors & Omissions
Insurance Policy
FREE
with each
Bond Order!
$
$
$
STATE REGULATION:
Effective July 1, 2007, the Secretary o f State is requiring
all NEW
& RENEWING Notaries to use a Self-Inking
Seal Stamp containing Name, Residence County,
Expiration Date and State issued ID Number.
Visit our website for pictures & descriptions
www.StegallNotaryService.com
Beautiful navy blue faux-leather
cover with gold embossed lettering.
Offered exclusively
by Stegall Notary Service.
A Stegall Notary
Service Exclusive!
MISSISSIPPI
OWNED & OPERATED
MISSISSIPPI
OWNED & OPERATED
Required by Law
MISSISSIPPI
Notary Public Official Record Book
Name on Credit Card: Call for Credit Card Information
Credit Card No.: Expiration Date: CVV No.:
Mark all Items you wish to order below.
Make check payable to STEGALL NOTARY SERVICE.
Return Order Form and Check or Credit Card information to:
P.O. Box 12913, Jackson, MS 39236
You MUST ALREADY BE COMMISSIONED by the STATE
ORDER FORM for EXISTING NOTARIES
INDIVI DUAL ITEM DESCRIPTION UNIT PRICE QTY. TOTAL
SUBTOTAL
Shipping
& Handling
TOTAL REMITTANCE
3 . State-Require d, Self-Inking Seal Sta mp
(see left)
Show s Name, County, Expiration Dat e and Notary I. D. #
4. “Mississippi” Notary Official Record Book
. kooba h t i ws l awet f o r r e non t ubi e s , r a t oNw enr o fd e r i uqeR
5. Notary Public Errors
&
Omissions Insurance
a. $10,000 4-year Policy
b. $15,000 4-year Policy
6. Notary Public Desk Plate
a. Regular
b. Personalized
7. Jurat Stamp
8. Stamp Ink, 1 oz, indicate color_____________
a. Rubber Stamp
b. Self-Inking Stamp
1 . Notary Public Statewide Commission
(4-year)
2. Notar y Public Bond (
$
5000, 4-year Surety)
(Include s
$
10,00 0 E rrors
&
Omission s Insurance)
ORD ER FORM for New or Renewal Commissions
EMAIL
: stegall@bellsouth.net
WEB
: www.StegallNotaryService.com
PHYSICA L ADDRESS
:
14 Northtown Drive
Jackson, MS 39211
MAILING ADDRESS
:
P.O. Box 12913
Jackson, MS 39236
PHONE
:
800.303.9505
601.957.9505
OWNERS
: J. Earl Stegall
& Maxine W. Stegall,
Licensed Insurance Agents
PLEASE FOLLOW THESE 3 STEPS: Note: Incomplete for ms will be returned.
POSTAL SHIPPING TO: PLEASE PRINT CLEARLY. (We ship via U.S. Postal Service)
Name: ______________________________________________________ MS Driver’s License No. _________________________
Name of Business at Mailing Address
(if any): ______________________________________ Bus./Daytime Phone: ___________________
Mailing Address:_________________________________________________________________________________________
City:_____________________________________________ State:_______________________ Zip: ___________________
Complete Notary Application AND have signature NOTARIZED.
Sign “Principal” line at the “X”, and
Sign the Oath of Office at the “X”, and have NOTARIZED.
DO NOT COMPLETE the TOP PORTION of the BOND.
Mark all Items or Kit you wish to order below.
Make check payable to STEGALL NOTARY SERVICE.
Return Order Form, Application, Bond and Check to: P.O. Box 12913, Jackson, MS 39236
YOU COMPLETE 2 STEPS ABOVE, WE WILL HANDLE THE REST.
We will obtain your Notary Commission, file your Bond with the Secretaryof State and send all your notary supplies to you promptly.
1
2
REQUIRED
$
10,000
Errors & Omissions
Insurance Policy
FREE
with each
Bond Order!
$
$
$
STATE REGULATION:
Effective July 1, 2007, the Secretary o f State is requiring
all NEW
& RENEWING Notaries to use a Self-Inking
Seal Stamp containing Name, Residence County,
Expiration Date and State issued ID Number.
Visit our website for pictures & descriptions
www.StegallNotaryService.com
Beautiful navy blue faux-leather
cover with gold embossed lettering.
Offered exclusively
by Stegall Notary Service.
A Stegall Notary
Service Exclusive!
MISSISSIPPI
OWNED & OPERATED
MISSISSIPPI
OWNED & OPERATED
Required by Law
MISSISSIPPI
Notary Public Official Record Book
$12.00
$30.00
$12.00
$50.00
$65.00
$9.00
$20.00
$4.75
$17.00
NOT WITH THIS FORM
Go to “Complete Process”
Section on Website Home Page
OUR SERVICES AND SUPPLIES COMPLY WITH MISSISSIPPI LAW AND ARE GUARANTEED TO BE LEGAL AND SATISFACTORY.
Notary ID #: Email Address:
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
0.00
8.00
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ORDER FORM for EXISTING NOTARIES (Stegall Notary Service)

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Completed 10 February 2021

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