Arizona Department of State Office of the Secretary of State
Katie Hobbs
, Secretary of State
Page 1 of 2
State of Arizona – Office of the Secretary of State
Statement of Complaint Against a Notary
SEND BY MAIL TO:
Secretary of State Katie Hobbs, Atten: Notary Division 1700
W. Washington Street, FL. 7, Phoenix, AZ 85007-2808
OR return this report in person:
PHOENIX - State Capitol Executive Tower,
1700 W. Washington Street, QG Fl., Room
TUCSON - Arizona State Complex,
400 W. Congress, 1st Fl., Suite 141
Office Hours: Monday through Friday, 8 a.m. to 5 p.m., except state holidays.
DO NOT WRITE IN THIS SPACE
FOR OFFICE USE ONLY
SOSBSCOMPLAINT REV. 01/07/2019
PLEASE NOTE: In order for the Arizona Secretary of State’s Office to initiate an investigation into possible
misconduct of an Arizona Notary Public, the complainant must put the grievance in writing.
INSTRUCTIONS
When to use this form: Use this form to file a statement of complaint
against an Arizona Notary Public. This form must be filled out by the
complainant. Anonymous complaints are not accepted.
Be Accurate: Complete all applicable fields on this form. Write legibly;
or fill out this application online.
Questions? Call (602) 542-6187; in-state/toll-free (800) 458-5842.
Submission: Submit this report to the address above. Any other
matters, please attach additional sheets with report.
Investigation Time-frame: Investigations may take up to 180 days to
conclude once received.
Website: All forms are available on the Secretary of State’s Website,
www.azsos.gov.
Limitations of Authority: The Arizona Secretary of State only has authority to take action against an Arizona Notary Public’s commission on file
with our office. The actions of this office do not preclude the complainant from taking any further legal action against the notary.
1. Complainant Information:
If a government agency is filing the grievance an individual must be identified who will serve as the point-of-contact while the investigation is conducted.
Complainant’s First Name Complainant’s Last Name Email Address
Address (include street, box or suite number) City State Zip Code
Phone Number (include area code)
( )
The complainant is the point-of-contact for the following government agency (optional)
2. Name of the Arizona Notary Public who has allegedly committed the notary violation(s)
First Name Middle Name or Initial (if used on notarization) Last Name
3. Transaction Information
Date the notarial act occurred
| |
Business Name (if applicable)
Address where the notarial act occurred City State Zip Code
List name(s) of any
person(s) witnessing
the notarial act
First Name Last Name Phone Number
( )
First Name Last Name Phone Number
( )
First Name Last Name Phone Number
( )
4. Type of Notarial Service(s) to Investigate
Check service(s) requested
acknowledgment jurat
List fee(s) charged for service(s) requested
oath and/or affirmation copy certification other
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