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ORDER FORM for New or Renewal Commissions
EMAIL
: stegall@bellsouth.net
WEB
: www.StegallNotaryService.com
PHYSICAL 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 forms 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: ___________________
Email Address:__________________________________________________________________________________________
STEP 1: APPLICATION
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 3 STEPS ABOVE, WE WILL HANDLE THE REST.
We will obtain your Notary Commission, file your Bond with the Secretary of State and send all your notary supplies to yo u promptly.
OUR SERVICES AND SUPPLIES COMPLY WITH MISSISSIPPI LAW AND ARE GUARANTEED TO BE LEGAL AND SATISFACTORY.
STEP 2: BOND
STEP 3: ORDER FORM
1
2
3
REQUIRED
$
10,000
Errors & Omissions
Insurance Policy
FREE
with each
Bond Order!
$
$
$
STATE REGULATION:
Effective July 1, 2007, the Secretary of 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.
Complete Notary Kit ...........
$
158.00
INCLUDES:
Statewide Commission (4-year)
$
5000 4-year Surety Bond
State-Required Seal Stamp (self-inking)
MISSISSIPPI Notary Record Book
$
20,000 Notary Errors
&
Omissions Insurance
Shipping
&
Handling
T
OTA L
S
AVINGS
O
F
$
12.00
Visit our website for pictures & descriptions
www.StegallNotaryService.com
MISSISSIPPI Notary Public
Official Record Book
Beautiful navy blue faux-leather cover
with gold embossed lettering. Offered
exclusively by Stegall Notary Service.
A Stegall Notary Service Exclu siv e!
MISSISSIPPI
OWNED & OPERATED
MISSISSIPPI
OWNED & OPERATED
INDIVIDUAL ITEM DESCRIPTION UNIT PRICE QTY. TOTAL
1. Notary Public Statewide Commission (4-year) $25.00
2. Notary Public Bond
(
$
5000, 4-year Surety)
$45.00
(Includes
$
10,000 Errors
&
Omissions Insurance)
3. State-Required, Self-Inking Seal Stamp (see left)
$25.00
Shows Name, County, Expiration Date and Notary I.D. #
4. Mississippi Notary Official Record Book
$10.00
Required for new Notaries, but not for renewals with a book.
5. COMPLETE NOTARY KIT $143.50
6. Notary Public Errors
&
Omissions Insurance
a.
$
10,000 4-y ear Policy $50.00
b.
$
15,000 4-year Policy $65.00
7. Notary Public Desk Plate
a. Regular $ 7.00
b. Personalized $12.00
8. Jurat Stamp
a. Rubber Stamp $ 9.00
b. Self-Inking Stamp $20.00
SUBTOTAL
Shipping
& Handling 7.00
TOTAL REM ITTANCE
total includes s&h
Required by Law
ORDER FORM for New or Renewal Commissions
EMAIL
: stegall@bellsouth.net
WEB
: www.StegallNotaryService.com
PHYSICAL 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 forms 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: ___________________
Email Address:__________________________________________________________________________________________
STEP 1: APPLICATION
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 3 STEPS ABOVE, WE WILL HANDLE THE REST.
We will obtain your Notary Commission, file your Bond with the Secretary of State and send all your notary supplies to yo u promptly.
OUR SERVICES AND SUPPLIES COMPLY WITH MISSISSIPPI LAW AND ARE GUARANTEED TO BE LEGAL AND SATISFACTORY.
STEP 2: BOND
STEP 3: ORDER FORM
1
2
3
REQUIRED
$
10,000
Errors & Omissions
Insurance Policy
FREE
with each
Bond Order!
$
$
$
STATE REGULATION:
Effective July 1, 2007, the Secretary of 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.
Complete Notary Kit ...........
$
158.00
INCLUDES:
Statewide Commission (4-year)
$
5000 4-year Surety Bond
State-Required Seal Stamp (self-inking)
MISSISSIPPI Notary Record Book
$
20,000 Notary Errors
&
Omissions Insurance
Shipping
&
Handling
T
OTA L
S
AVINGS
O
F
$
12.00
Visit our website for pictures & descriptions
www.StegallNotaryService.com
MISSISSIPPI Notary Public
Official Record Book
Beautiful navy blue faux-leather cover
with gold embossed lettering. Offered
exclusively by Stegall Notary Service.
A Stegall Notary Service Exclu siv e!
MISSISSIPPI
OWNED & OPERATED
MISSISSIPPI
OWNED & OPERATED
INDIVIDUAL ITEM DESCRIPTION UNIT PRICE QTY. TOTAL
1. Notary Public Statewide Commission (4-year) $25.00
2. Notary Public Bond
(
$
5000, 4-year Surety)
$45.00
(Includes
$
10,000 Errors
&
Omissions Insurance)
3. State-Required, Self-Inking Seal Stamp (see left)
$25.00
Shows Name, County, Expiration Date and Notary I.D. #
4. Mississippi Notary Official Record Book
$10.00
Required for new Notaries, but not for renewals with a book.
5. COMPLETE NOTARY KIT $143.50
6. Notary Public Errors
&
Omissions Insurance
a.
$
10,000 4-y ear Policy $50.00
b.
$
15,000 4-year Policy $65.00
7. Notary Public Desk Plate
a. Regular $ 7.00
b. Personalized $12.00
8. Jurat Stamp
a. Rubber Stamp $ 9.00
b. Self-Inking Stamp $20.00
SUBTOTAL
Shipping
& Handling 7.00
TOTAL REM ITTANCE
total includes s&h
Required by Law
ORDER FORM for New or Renewal Commissions
EMAIL
: stegall@bellsouth.net
WEB
: www.StegallNotaryService.com
PHYSICAL 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 forms 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: ___________________
Email Address:__________________________________________________________________________________________
STEP 1: APPLICATION
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 3 STEPS ABOVE, WE WILL HANDLE THE REST.
We will obtain your Notary Commission, file your Bond with the Secretary of State and send all your notary supplies to yo u promptly.
OUR SERVICES AND SUPPLIES COMPLY WITH MISSISSIPPI LAW AND ARE GUARANTEED TO BE LEGAL AND SATISFACTORY.
STEP 2: BOND
STEP 3: ORDER FORM
1
2
3
REQUIRED
$
10,000
Errors & Omissions
Insurance Policy
FREE
with each
Bond Order!
$
$
$
STATE REGULATION:
Effective July 1, 2007, the Secretary of 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.
Complete Notary Kit ...........
$
158.00
INCLUDES:
Statewide Commission (4-year)
$
5000 4-year Surety Bond
State-Required Seal Stamp (self-inking)
MISSISSIPPI Notary Record Book
$
20,000 Notary Errors
&
Omissions Insurance
Shipping
&
Handling
T
OTA L
S
AVINGS
O
F
$
12.00
Visit our website for pictures & descriptions
www.StegallNotaryService.com
MISSISSIPPI Notary Public
Official Record Book
Beautiful navy blue faux-leather cover
with gold embossed lettering. Offered
exclusively by Stegall Notary Service.
A Stegall Notary Service Exclu siv e!
MISSISSIPPI
OWNED & OPERATED
MISSISSIPPI
OWNED & OPERATED
INDIVIDUAL ITEM DESCRIPTION UNIT PRICE QTY. TOTAL
1. Notary Public Statewide Commission (4-year) $25.00
2. Notary Public Bond
(
$
5000, 4-year Surety)
$45.00
(Includes
$
10,000 Errors
&
Omissions Insurance)
3. State-Required, Self-Inking Seal Stamp (see left)
$25.00
Shows Name, County, Expiration Date and Notary I.D. #
4. Mississippi Notary Official Record Book
$10.00
Required for new Notaries, but not for renewals with a book.
5. COMPLETE NOTARY KIT $143.50
6. Notary Public Errors
&
Omissions Insurance
a.
$
10,000 4-y ear Policy $50.00
b.
$
15,000 4-year Policy $65.00
7. Notary Public Desk Plate
a. Regular $ 7.00
b. Personalized $12.00
8. Jurat Stamp
a. Rubber Stamp $ 9.00
b. Self-Inking Stamp $20.00
SUBTOTAL
Shipping
& Handling 7.00
TOTAL REM ITTANCE
total includes s&h
Required by Law
OWNER: Cooper D. Allen
Licensed Insurance Agent
ORDER FORM for New or Renewal Commissions
EMAIL
: stegall@bellsouth.net
WEB
: www.StegallNotaryService.com
PHYSICAL 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 forms 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: ___________________
Email Address:__________________________________________________________________________________________
STEP 1: APPLICATION
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 3 STEPS ABOVE, WE WILL HANDLE THE REST.
We will obtain your Notary Commission, file your Bond with the Secretary of State and send all your notary supplies to yo u promptly.
OUR SERVICES AND SUPPLIES COMPLY WITH MISSISSIPPI LAW AND ARE GUARANTEED TO BE LEGAL AND SATISFACTORY.
STEP 2: BOND
STEP 3: ORDER FORM
1
2
3
REQUIRED
$
10,000
Errors & Omissions
Insurance Policy
FREE
with each
Bond Order!
$
$
$
STATE REGULATION:
Effective July 1, 2007, the Secretary of 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.
Complete Notary Kit ...........
$
158.00
INCLUDES:
Statewide Commission (4-year)
$
5000 4-year Surety Bond
State-Required Seal Stamp (self-inking)
MISSISSIPPI Notary Record Book
$
20,000 Notary Errors
&
Omissions Insurance
Shipping
&
Handling
T
OTA L
S
AVINGS
O
F
$
12.00
Visit our website for pictures & descriptions
www.StegallNotaryService.com
MISSISSIPPI Notary Public
Official Record Book
Beautiful navy blue faux-leather cover
with gold embossed lettering. Offered
exclusively by Stegall Notary Service.
A Stegall Notary Service Exclu siv e!
MISSISSIPPI
OWNED & OPERATED
MISSISSIPPI
OWNED & OPERATED
INDIVIDUAL ITEM DESCRIPTION UNIT PRICE QTY. TOTAL
1. Notary Public Statewide Commission (4-year) $25.00
2. Notary Public Bond
(
$
5000, 4-year Surety)
$45.00
(Includes
$
10,000 Errors
&
Omissions Insurance)
3. State-Required, Self-Inking Seal Stamp (see left)
$25.00
Shows Name, County, Expiration Date and Notary I.D. #
4. Mississippi Notary Official Record Book
$10.00
Required for new Notaries, but not for renewals with a book.
5. COMPLETE NOTARY KIT $143.50
6. Notary Public Errors
&
Omissions Insurance
a.
$
10,000 4-y ear Policy $50.00
b.
$
15,000 4-year Policy $65.00
7. Notary Public Desk Plate
a. Regular $ 7.00
b. Personalized $12.00
8. Jurat Stamp
a. Rubber Stamp $ 9.00
b. Self-Inking Stamp $20.00
SUBTOTAL
Shipping
& Handling 7.00
TOTAL REM ITTANCE
total includes s&h
Required by Law
ORDER FORM for New or Renewal Commissions
EMAIL
: stegall@bellsouth.net
WEB
: www.StegallNotaryService.com
PHYSICAL 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 forms 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: ___________________
Email Address:__________________________________________________________________________________________
STEP 1: APPLICATION
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 3 STEPS ABOVE, WE WILL HANDLE THE REST.
We will obtain your Notary Commission, file your Bond with the Secretary of State and send all your notary supplies to yo u promptly.
OUR SERVICES AND SUPPLIES COMPLY WITH MISSISSIPPI LAW AND ARE GUARANTEED TO BE LEGAL AND SATISFACTORY.
STEP 2: BOND
STEP 3: ORDER FORM
1
2
3
REQUIRED
$
10,000
Errors & Omissions
Insurance Policy
FREE
with each
Bond Order!
$
$
$
STATE REGULATION:
Effective July 1, 2007, the Secretary of 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.
Complete Notary Kit ...........
$
158.00
INCLUDES:
Statewide Commission (4-year)
$
5000 4-year Surety Bond
State-Required Seal Stamp (self-inking)
MISSISSIPPI Notary Record Book
$
20,000 Notary Errors
&
Omissions Insurance
Shipping
&
Handling
T
OTA L
S
AVINGS
O
F
$
12.00
Visit our website for pictures & descriptions
www.StegallNotaryService.com
MISSISSIPPI Notary Public
Official Record Book
Beautiful navy blue faux-leather cover
with gold embossed lettering. Offered
exclusively by Stegall Notary Service.
A Stegall Notary Service Exclu siv e!
MISSISSIPPI
OWNED & OPERATED
MISSISSIPPI
OWNED & OPERATED
INDIVIDUAL ITEM DESCRIPTION UNIT PRICE QTY. TOTAL
1. Notary Public Statewide Commission (4-year) $25.00
2. Notary Public Bond
(
$
5000, 4-year Surety)
$45.00
(Includes
$
10,000 Errors
&
Omissions Insurance)
3. State-Required, Self-Inking Seal Stamp (see left)
$25.00
Shows Name, County, Expiration Date and Notary I.D. #
4. Mississippi Notary Official Record Book
$10.00
Required for new Notaries, but not for renewals with a book.
5. COMPLETE NOTARY KIT $143.50
6. Notary Public Errors
&
Omissions Insurance
a.
$
10,000 4-y ear Policy $50.00
b.
$
15,000 4-year Policy $65.00
7. Notary Public Desk Plate
a. Regular $ 7.00
b. Personalized $12.00
8. Jurat Stamp
a. Rubber Stamp $ 9.00
b. Self-Inking Stamp $20.00
SUBTOTAL
Shipping
& Handling 7.00
TOTAL REM ITTANCE
total includes s&h
Required by Law
ORDER FORM for New or Renewal Commissions
EMAIL
: stegall@bellsouth.net
WEB
: www.StegallNotaryService.com
PHYSICAL 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 forms 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: ___________________
Email Address:__________________________________________________________________________________________
STEP 1: APPLICATION
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 3 STEPS ABOVE, WE WILL HANDLE THE REST.
We will obtain your Notary Commission, file your Bond with the Secretary of State and send all your notary supplies to yo u promptly.
OUR SERVICES AND SUPPLIES COMPLY WITH MISSISSIPPI LAW AND ARE GUARANTEED TO BE LEGAL AND SATISFACTORY.
STEP 2: BOND
STEP 3: ORDER FORM
1
2
3
REQUIRED
$
10,000
Errors & Omissions
Insurance Policy
FREE
with each
Bond Order!
$
$
$
STATE REGULATION:
Effective July 1, 2007, the Secretary of 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.
Complete Notary Kit ...........
$
158.00
INCLUDES:
Statewide Commission (4-year)
$
5000 4-year Surety Bond
State-Required Seal Stamp (self-inking)
MISSISSIPPI Notary Record Book
$
20,000 Notary Errors
&
Omissions Insurance
Shipping
&
Handling
T
OTA L
S
AVINGS
O
F
$
12.00
Visit our website for pictures & descriptions
www.StegallNotaryService.com
MISSISSIPPI Notary Public
Official Record Book
Beautiful navy blue faux-leather cover
with gold embossed lettering. Offered
exclusively by Stegall Notary Service.
A Stegall Notary Service Exclu siv e!
MISSISSIPPI
OWNED & OPERATED
MISSISSIPPI
OWNED & OPERATED
INDIVIDUAL ITEM DESCRIPTION UNIT PRICE QTY. TOTAL
1. Notary Public Statewide Commission (4-year) $25.00
2. Notary Public Bond
(
$
5000, 4-year Surety)
$45.00
(Includes
$
10,000 Errors
&
Omissions Insurance)
3. State-Required, Self-Inking Seal Stamp (see left)
$25.00
Shows Name, County, Expiration Date and Notary I.D. #
4. Mississippi Notary Official Record Book
$10.00
Required for new Notaries, but not for renewals with a book.
5. COMPLETE NOTARY KIT $143.50
6. Notary Public Errors
&
Omissions Insurance
a.
$
10,000 4-y ear Policy $50.00
b.
$
15,000 4-year Policy $65.00
7. Notary Public Desk Plate
a. Regular $ 7.00
b. Personalized $12.00
8. Jurat Stamp
a. Rubber Stamp $ 9.00
b. Self-Inking Stamp $20.00
SUBTOTAL
Shipping
& Handling 7.00
TOTAL REM ITTANCE
total includes s&h
Required by Law
ORDER FORM for New or Renewal Commissions
EMAIL
: stegall@bellsouth.net
WEB
: www.StegallNotaryService.com
PHYSICAL 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 forms 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: ___________________
Email Address:__________________________________________________________________________________________
STEP 1: APPLICATION
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 3 STEPS ABOVE, WE WILL HANDLE THE REST.
We will obtain your Notary Commission, file your Bond with the Secretary of State and send all your notary supplies to yo u promptly.
OUR SERVICES AND SUPPLIES COMPLY WITH MISSISSIPPI LAW AND ARE GUARANTEED TO BE LEGAL AND SATISFACTORY.
STEP 2: BOND
STEP 3: ORDER FORM
1
2
3
REQUIRED
$
10,000
Errors & Omissions
Insurance Policy
FREE
with each
Bond Order!
$
$
$
STATE REGULATION:
Effective July 1, 2007, the Secretary of 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.
Complete Notary Kit ...........
$
158.00
INCLUDES:
Statewide Commission (4-year)
$
5000 4-year Surety Bond
State-Required Seal Stamp (self-inking)
MISSISSIPPI Notary Record Book
$
20,000 Notary Errors
&
Omissions Insurance
Shipping
&
Handling
T
OTA L
S
AVINGS
O
F
$
12.00
Visit our website for pictures & descriptions
www.StegallNotaryService.com
MISSISSIPPI Notary Public
Official Record Book
Beautiful navy blue faux-leather cover
with gold embossed lettering. Offered
exclusively by Stegall Notary Service.
A Stegall Notary Service Exclu siv e!
MISSISSIPPI
OWNED & OPERATED
MISSISSIPPI
OWNED & OPERATED
INDIVIDUAL ITEM DESCRIPTION UNIT PRICE QTY. TOTAL
1. Notary Public Statewide Commission (4-year) $25.00
2. Notary Public Bond
(
$
5000, 4-year Surety)
$45.00
(Includes
$
10,000 Errors
&
Omissions Insurance)
3. State-Required, Self-Inking Seal Stamp (see left)
$25.00
Shows Name, County, Expiration Date and Notary I.D. #
4. Mississippi Notary Official Record Book
$10.00
Required for new Notaries, but not for renewals with a book.
5. COMPLETE NOTARY KIT $143.50
6. Notary Public Errors
&
Omissions Insurance
a.
$
10,000 4-y ear Policy $50.00
b.
$
15,000 4-year Policy $65.00
7. Notary Public Desk Plate
a. Regular $ 7.00
b. Personalized $12.00
8. Jurat Stamp
a. Rubber Stamp $ 9.00
b. Self-Inking Stamp $20.00
SUBTOTAL
Shipping
& Handling 7.00
TOTAL REM ITTANCE
total includes s&h
Required by Law
ORDER 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 forms 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: ___________________
Email Address:__________________________________________________________________________________________
STEP 1: APPLICATION
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 3 STEPS ABOVE, WE WILL HANDLE THE REST.
We will obtain your Notary Commission, file your Bond with the Secretary of State and send all your notary supplies to yo u promptly.
OUR SERVICES AND SUPPLIES COMPLY WITH MISSISSIPPI LAW AND ARE GUARANTEED TO BE LEGAL AND SATISFACTORY.
STEP 2: BOND
STEP 3: ORDER FORM
1
2
3
REQUIRED
$
10,000
Errors & Omissions
Insurance Policy
FREE
with each
Bond Order!
$
$
$
STATE REGULATION:
Effective July 1, 2007, the Secretary of 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.
Complete Notary Kit ...........
$
158.00
INCLUDES:
Statewide Commission (4-year)
$
5000 4-year Surety Bond
State-Required Seal Stamp (self-inking)
MISSISSIPPI Notary Record Book
$
20,000 Notary Errors
&
Omissions Insurance
Shipping
&
Handling
T
OTA L
S
AVINGS
O
F
$
12.00
Visit our website for pictures & descriptions
www.StegallNotaryService.com
MISSISSIPPI Notary Public
Official Record Book
Beautiful navy blue faux-leather cover
with gold embossed lettering. Offered
exclusively by Stegall Notary Service.
A Stegall Notary Service Exclu siv e!
MISSISSIPPI
OWNED & OPERATED
MISSISSIPPI
OWNED & OPERATED
INDIVIDUAL ITEM DESCRIPTION UNIT PRICE QTY. TOTAL
1. Notary Public Statewide Commission (4-year) $25.00
2. Notary Public Bond
(
$
5000, 4-year Surety)
$45.00
(Includes
$
10,000 Errors
&
Omissions Insurance)
3. State-Required, Self-Inking Seal Stamp (see left)
$25.00
Shows Name, County, Expiration Date and Notary I.D. #
4. Mississippi Notary Official Record Book
$10.00
Required for new Notaries, but not for renewals with a book.
5. COMPLETE NOTARY KIT $143.50
6. Notary Public Errors
&
Omissions Insurance
a.
$
10,000 4-y ear Policy $50.00
b.
$
15,000 4-year Policy $65.00
7. Notary Public Desk Plate
a. Regular $ 7.00
b. Personalized $12.00
8. Jurat Stamp
a. Rubber Stamp $ 9.00
b. Self-Inking Stamp $20.00
SUBTOTAL
Shipping
& Handling 7.00
TOTAL REM ITTANCE
total includes s&h
Required by Law
ORDER FORM for New or Renewal Commissions
EMAIL
: stegall@bellsouth.net
WEB
: www.StegallNotaryService.com
PHYSICAL 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 forms 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: ___________________
Email Address:__________________________________________________________________________________________
STEP 1: APPLICATION
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 3 STEPS ABOVE, WE WILL HANDLE THE REST.
We will obtain your Notary Commission, file your Bond with the Secretary of State and send all your notary supplies to yo u promptly.
OUR SERVICES AND SUPPLIES COMPLY WITH MISSISSIPPI LAW AND ARE GUARANTEED TO BE LEGAL AND SATISFACTORY.
STEP 2: BOND
STEP 3: ORDER FORM
1
2
3
REQUIRED
$
10,000
Errors & Omissions
Insurance Policy
FREE
with each
Bond Order!
$
$
$
STATE REGULATION:
Effective July 1, 2007, the Secretary of 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.
Complete Notary Kit ...........
$
158.00
INCLUDES:
Statewide Commission (4-year)
$
5000 4-year Surety Bond
State-Required Seal Stamp (self-inking)
MISSISSIPPI Notary Record Book
$
20,000 Notary Errors
&
Omissions Insurance
Shipping
&
Handling
T
OTA L
S
AVINGS
O
F
$
12.00
Visit our website for pictures & descriptions
www.StegallNotaryService.com
MISSISSIPPI Notary Public
Official Record Book
Beautiful navy blue faux-leather cover
with gold embossed lettering. Offered
exclusively by Stegall Notary Service.
A Stegall Notary Service Exclu siv e!
MISSISSIPPI
OWNED & OPERATED
MISSISSIPPI
OWNED & OPERATED
INDIVIDUAL ITEM DESCRIPTION UNIT PRICE QTY. TOTAL
1. Notary Public Statewide Commission (4-year) $25.00
2. Notary Public Bond
(
$
5000, 4-year Surety)
$45.00
(Includes
$
10,000 Errors
&
Omissions Insurance)
3. State-Required, Self-Inking Seal Stamp (see left)
$25.00
Shows Name, County, Expiration Date and Notary I.D. #
4. Mississippi Notary Official Record Book
$10.00
Required for new Notaries, but not for renewals with a book.
5. COMPLETE NOTARY KIT $143.50
6. Notary Public Errors
&
Omissions Insurance
a.
$
10,000 4-y ear Policy $50.00
b.
$
15,000 4-year Policy $65.00
7. Notary Public Desk Plate
a. Regular $ 7.00
b. Personalized $12.00
8. Jurat Stamp
a. Rubber Stamp $ 9.00
b. Self-Inking Stamp $20.00
SUBTOTAL
Shipping
& Handling 7.00
TOTAL REM ITTANCE
total includes s&h
Required by Law
PLEASE FOLLOW THESE 3 STEPS:
Note: Incomplete forms will be returned.
ORDER FORM for New or Renewal Commissions
EMAIL
: stegall@bellsouth.net
WEB
: www.StegallNotaryService.com
PHYSICAL 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 forms 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: ___________________
Email Address:__________________________________________________________________________________________
STEP 1: APPLICATION
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 3 STEPS ABOVE, WE WILL HANDLE THE REST.
We will obtain your Notary Commission, file your Bond with the Secretary of State and send all your notary supplies to yo u promptly.
OUR SERVICES AND SUPPLIES COMPLY WITH MISSISSIPPI LAW AND ARE GUARANTEED TO BE LEGAL AND SATISFACTORY.
STEP 2: BOND
STEP 3: ORDER FORM
1
2
3
REQUIRED
$
10,000
Errors & Omissions
Insurance Policy
FREE
with each
Bond Order!
$
$
$
STATE REGULATION:
Effective July 1, 2007, the Secretary of 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.
Complete Notary Kit ...........
$
158.00
INCLUDES:
Statewide Commission (4-year)
$
5000 4-year Surety Bond
State-Required Seal Stamp (self-inking)
MISSISSIPPI Notary Record Book
$
20,000 Notary Errors
&
Omissions Insurance
Shipping
&
Handling
T
OTA L
S
AVINGS
O
F
$
12.00
Visit our website for pictures & descriptions
www.StegallNotaryService.com
MISSISSIPPI Notary Public
Official Record Book
Beautiful navy blue faux-leather cover
with gold embossed lettering. Offered
exclusively by Stegall Notary Service.
A Stegall Notary Service Exclu siv e!
MISSISSIPPI
OWNED & OPERATED
MISSISSIPPI
OWNED & OPERATED
INDIVIDUAL ITEM DESCRIPTION UNIT PRICE QTY. TOTAL
1. Notary Public Statewide Commission (4-year) $25.00
2. Notary Public Bond
(
$
5000, 4-year Surety)
$45.00
(Includes
$
10,000 Errors
&
Omissions Insurance)
3. State-Required, Self-Inking Seal Stamp (see left)
$25.00
Shows Name, County, Expiration Date and Notary I.D. #
4. Mississippi Notary Official Record Book
$10.00
Required for new Notaries, but not for renewals with a book.
5. COMPLETE NOTARY KIT $143.50
6. Notary Public Errors
&
Omissions Insurance
a.
$
10,000 4-y ear Policy $50.00
b.
$
15,000 4-year Policy $65.00
7. Notary Public Desk Plate
a. Regular $ 7.00
b. Personalized $12.00
8. Jurat Stamp
a. Rubber Stamp $ 9.00
b. Self-Inking Stamp $20.00
SUBTOTAL
Shipping
& Handling 7.00
TOTAL REM ITTANCE
total includes s&h
Required by Law
v 02.18
$150.00
$12.00
$30.00
$12.00
8.00
$17.00
ORDER FORM for New or Renewal Commissions
EMAIL
: stegall@bellsouth.net
WEB
: www.StegallNotaryService.com
PHYSICAL 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 forms 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: ___________________
Email Address:__________________________________________________________________________________________
STEP 1: APPLICATION
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 3 STEPS ABOVE, WE WILL HANDLE THE REST.
We will obtain your Notary Commission, file your Bond with the Secretary of State and send all your notary supplies to yo u promptly.
OUR SERVICES AND SUPPLIES COMPLY WITH MISSISSIPPI LAW AND ARE GUARANTEED TO BE LEGAL AND SATISFACTORY.
STEP 2: BOND
STEP 3: ORDER FORM
1
2
3
REQUIRED
$
10,000
Errors & Omissions
Insurance Policy
FREE
with each
Bond Order!
$
$
$
STATE REGULATION:
Effective July 1, 2007, the Secretary of 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.
Complete Notary Kit ...........
$
158.00
INCLUDES:
Statewide Commission (4-year)
$
5000 4-year Surety Bond
State-Required Seal Stamp (self-inking)
MISSISSIPPI Notary Record Book
$
20,000 Notary Errors
&
Omissions Insurance
Shipping
&
Handling
T
OTA L
S
AVINGS
O
F
$
12.00
Visit our website for pictures & descriptions
www.StegallNotaryService.com
MISSISSIPPI Notary Public
Official Record Book
Beautiful navy blue faux-leather cover
with gold embossed lettering. Offered
exclusively by Stegall Notary Service.
A Stegall Notary Service Exclu siv e!
MISSISSIPPI
OWNED & OPERATED
MISSISSIPPI
OWNED & OPERATED
INDIVIDUAL ITEM DESCRIPTION UNIT PRICE QTY. TOTAL
1. Notary Public Statewide Commission (4-year) $25.00
2. Notary Public Bond
(
$
5000, 4-year Surety)
$45.00
(Includes
$
10,000 Errors
&
Omissions Insurance)
3. State-Required, Self-Inking Seal Stamp (see left)
$25.00
Shows Name, County, Expiration Date and Notary I.D. #
4. Mississippi Notary Official Record Book
$10.00
Required for new Notaries, but not for renewals with a book.
5. COMPLETE NOTARY KIT $143.50
6. Notary Public Errors
&
Omissions Insurance
a.
$
10,000 4-y ear Policy $50.00
b.
$
15,000 4-year Policy $65.00
7. Notary Public Desk Plate
a. Regular $ 7.00
b. Personalized $12.00
8. Jurat Stamp
a. Rubber Stamp $ 9.00
b. Self-Inking Stamp $20.00
SUBTOTAL
Shipping
& Handling 7.00
TOTAL REM ITTANCE
total includes s&h
Required by Law
ORDER FORM for New or Renewal Commissions
EMAIL
: stegall@bellsouth.net
WEB
: www.StegallNotaryService.com
PHYSICAL 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 forms 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: ___________________
Email Address:__________________________________________________________________________________________
STEP 1: APPLICATION
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 3 STEPS ABOVE, WE WILL HANDLE THE REST.
We will obtain your Notary Commission, file your Bond with the Secretary of State and send all your notary supplies to yo u promptly.
OUR SERVICES AND SUPPLIES COMPLY WITH MISSISSIPPI LAW AND ARE GUARANTEED TO BE LEGAL AND SATISFACTORY.
STEP 2: BOND
STEP 3: ORDER FORM
1
2
3
REQUIRED
$
10,000
Errors & Omissions
Insurance Policy
FREE
with each
Bond Order!
$
$
$
STATE REGULATION:
Effective July 1, 2007, the Secretary of 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.
Complete Notary Kit ...........
$
158.00
INCLUDES:
Statewide Commission (4-year)
$
5000 4-year Surety Bond
State-Required Seal Stamp (self-inking)
MISSISSIPPI Notary Record Book
$
20,000 Notary Errors
&
Omissions Insurance
Shipping
&
Handling
T
OTA L
S
AVINGS
O
F
$
12.00
Visit our website for pictures & descriptions
www.StegallNotaryService.com
MISSISSIPPI Notary Public
Official Record Book
Beautiful navy blue faux-leather cover
with gold embossed lettering. Offered
exclusively by Stegall Notary Service.
A Stegall Notary Service Exclu siv e!
MISSISSIPPI
OWNED & OPERATED
MISSISSIPPI
OWNED & OPERATED
INDIVIDUAL ITEM DESCRIPTION UNIT PRICE QTY. TOTAL
1. Notary Public Statewide Commission (4-year) $25.00
2. Notary Public Bond
(
$
5000, 4-year Surety)
$45.00
(Includes
$
10,000 Errors
&
Omissions Insurance)
3. State-Required, Self-Inking Seal Stamp (see left)
$25.00
Shows Name, County, Expiration Date and Notary I.D. #
4. Mississippi Notary Official Record Book
$10.00
Required for new Notaries, but not for renewals with a book.
5. COMPLETE NOTARY KIT $143.50
6. Notary Public Errors
&
Omissions Insurance
a.
$
10,000 4-y ear Policy $50.00
b.
$
15,000 4-year Policy $65.00
7. Notary Public Desk Plate
a. Regular $ 7.00
b. Personalized $12.00
8. Jurat Stamp
a. Rubber Stamp $ 9.00
b. Self-Inking Stamp $20.00
SUBTOTAL
Shipping
& Handling 7.00
TOTAL REM ITTANCE
total includes s&h
Required by Law
ORDER FORM for New or Renewal Commissions
EMAIL
: stegall@bellsouth.net
WEB
: www.StegallNotaryService.com
PHYSICAL 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 forms 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: ___________________
Email Address:__________________________________________________________________________________________
STEP 1: APPLICATION
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 3 STEPS ABOVE, WE WILL HANDLE THE REST.
We will obtain your Notary Commission, file your Bond with the Secretary of State and send all your notary supplies to yo u promptly.
OUR SERVICES AND SUPPLIES COMPLY WITH MISSISSIPPI LAW AND ARE GUARANTEED TO BE LEGAL AND SATISFACTORY.
STEP 2: BOND
STEP 3: ORDER FORM
1
2
3
REQUIRED
$
10,000
Errors & Omissions
Insurance Policy
FREE
with each
Bond Order!
$
$
$
STATE REGULATION:
Effective July 1, 2007, the Secretary of 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.
Complete Notary Kit ...........
$
158.00
INCLUDES:
Statewide Commission (4-year)
$
5000 4-year Surety Bond
State-Required Seal Stamp (self-inking)
MISSISSIPPI Notary Record Book
$
20,000 Notary Errors
&
Omissions Insurance
Shipping
&
Handling
T
OTA L
S
AVINGS
O
F
$
12.00
Visit our website for pictures & descriptions
www.StegallNotaryService.com
MISSISSIPPI Notary Public
Official Record Book
Beautiful navy blue faux-leather cover
with gold embossed lettering. Offered
exclusively by Stegall Notary Service.
A Stegall Notary Service Exclu siv e!
MISSISSIPPI
OWNED & OPERATED
MISSISSIPPI
OWNED & OPERATED
INDIVIDUAL ITEM DESCRIPTION UNIT PRICE QTY. TOTAL
1. Notary Public Statewide Commission (4-year) $25.00
2. Notary Public Bond
(
$
5000, 4-year Surety)
$45.00
(Includes
$
10,000 Errors
&
Omissions Insurance)
3. State-Required, Self-Inking Seal Stamp (see left)
$25.00
Shows Name, County, Expiration Date and Notary I.D. #
4. Mississippi Notary Official Record Book
$10.00
Required for new Notaries, but not for renewals with a book.
5. COMPLETE NOTARY KIT $143.50
6. Notary Public Errors
&
Omissions Insurance
a.
$
10,000 4-y ear Policy $50.00
b.
$
15,000 4-year Policy $65.00
7. Notary Public Desk Plate
a. Regular $ 7.00
b. Personalized $12.00
8. Jurat Stamp
a. Rubber Stamp $ 9.00
b. Self-Inking Stamp $20.00
SUBTOTAL
Shipping
& Handling 7.00
TOTAL REM ITTANCE
total includes s&h
Required by Law
ORDER FORM for New or Renewal Commissions
EMAIL
: stegall@bellsouth.net
WEB
: www.StegallNotaryService.com
PHYSICAL 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 forms 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: ___________________
Email Address:__________________________________________________________________________________________
STEP 1: APPLICATION
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 3 STEPS ABOVE, WE WILL HANDLE THE REST.
We will obtain your Notary Commission, file your Bond with the Secretary of State and send all your notary supplies to yo u promptly.
OUR SERVICES AND SUPPLIES COMPLY WITH MISSISSIPPI LAW AND ARE GUARANTEED TO BE LEGAL AND SATISFACTORY.
STEP 2: BOND
STEP 3: ORDER FORM
1
2
3
REQUIRED
$
10,000
Errors & Omissions
Insurance Policy
FREE
with each
Bond Order!
$
$
$
STATE REGULATION:
Effective July 1, 2007, the Secretary of 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.
Complete Notary Kit ...........
$
158.00
INCLUDES:
Statewide Commission (4-year)
$
5000 4-year Surety Bond
State-Required Seal Stamp (self-inking)
MISSISSIPPI Notary Record Book
$
20,000 Notary Errors
&
Omissions Insurance
Shipping
&
Handling
T
OTA L
S
AVINGS
O
F
$
12.00
Visit our website for pictures & descriptions
www.StegallNotaryService.com
MISSISSIPPI Notary Public
Official Record Book
Beautiful navy blue faux-leather cover
with gold embossed lettering. Offered
exclusively by Stegall Notary Service.
A Stegall Notary Service Exclu siv e!
MISSISSIPPI
OWNED & OPERATED
MISSISSIPPI
OWNED & OPERATED
INDIVIDUAL ITEM DESCRIPTION UNIT PRICE QTY. TOTAL
1. Notary Public Statewide Commission (4-year) $25.00
2. Notary Public Bond
(
$
5000, 4-year Surety)
$45.00
(Includes
$
10,000 Errors
&
Omissions Insurance)
3. State-Required, Self-Inking Seal Stamp (see left)
$25.00
Shows Name, County, Expiration Date and Notary I.D. #
4. Mississippi Notary Official Record Book
$10.00
Required for new Notaries, but not for renewals with a book.
5. COMPLETE NOTARY KIT $143.50
6. Notary Public Errors
&
Omissions Insurance
a.
$
10,000 4-y ear Policy $50.00
b.
$
15,000 4-year Policy $65.00
7. Notary Public Desk Plate
a. Regular $ 7.00
b. Personalized $12.00
8. Jurat Stamp
a. Rubber Stamp $ 9.00
b. Self-Inking Stamp $20.00
SUBTOTAL
Shipping
& Handling 7.00
TOTAL REM ITTANCE
total includes s&h
Required by Law
Name on Credit Card: Call for Credit Card Information
Credit Card No.: Expiration Date: CVV No.:
Mark all Items or Kit you wish to order below.
Make check payable to STEGALL NOTARY SERVICE.
Return Order Form, Application, Bond, and Check or Credit Card information to:
P.O. Box 12913, Jackson, MS 39236
0.00
8.00
MISSISSIPPI SECRETARY OF STATE
Jackson, Mississippi
NOTARY PUBLIC COMMISSION APPLICATION
This application must be typed or printed in ink. Fields marked with an asterisk (*) are required.
*This application is a New Commission, or a Re-Commission ---
>
Expiration date / / .
( check only one )
Notary ID Number: _____
(Provided by Secretary of State)
*I, _____________, hereby make application for appointment
(Name exactly as you wish it to appear on your certificate. No nickname or alias.)
to the office of Notary Public.
Under penalty of perjury, I hereby certify that: I have read the Notary Public Regulations and instructions and understand the
qualifications for appointment to the office of Notary Public (www.sos.state.ms.us/busserv/notaries); I am at least 18 years of age,
and I have never been convicted of a disqualifying felony; I can read and write the English language; I am a Citizen, or other legal
resident of the United States; and I have been a legal resident in the State of Mississippi for more than thirty (30) days and reside
at the following physical address:
RESIDENCE
*Street Address: *City: *MS Zip:
*Telephone Number: *MS Driver License #:
(Or non-driver state ID number)
*County of Residence: __ *Date of Birth: / / PIN:
(Last four digits of SSN)
Mailing address, if different: City: MS Zip:
*E-mail address: ___________________________________________________
NOTICE: After filing with the Secretary of State's Office, this document is a public record. The personal information contained
in this application is used by the Secretary of State to determine your eligibility for the Office of Notary Public.
Please provide a business or employer address and telephone number as you would like it to appear in the online
Notary Directory. If you do not provide this information you will be listed at your mailing or residence address.
BUSINESS Name: Job Title: Phone: ___
Street Address: City: Zip:
Mailing Address: City: Zip:
I swear or affirm that the above information is true and correct. __
* Applicant Signature
State of Mississippi, County of _________________
Sworn to and subscribed before me this day of , 20 .
*Notary Public
My Commission Expires: __
(SEAL)
14 Northtown Drive
Jackson, Mississippi 39211
FORM 11NP001
v 09.14
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Completed 8 February 2021

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