Upload
nguyenmien
View
217
Download
2
Embed Size (px)
Citation preview
STATE OF IDAHONOTARY PUBLIC COMMISSIONNAME OR ADDRESS CHANGE
611
This block for Secretary of State use only.
DO NOTSTAMP, WRITE,
OR SIGNIN THIS
AREA
Notary Signature:
Rev. 07/2017
NAME CHANGE: Enter your name exactly as it will appear on your new notary seal.First Name: Middle Name or Initial (if used):Last Name: Suffix (Jr., Sr., ect.):
Physical Address (not a PO Box): City: State: Zipcode:CHANGE PHYSICAL ADDRESS: Enter your new physical address. This must be a street address, not a PO Box.
Name and Mailing Address (if different from physical address): City: State: Zipcode:CHANGE MAILING ADDRESS: Enter your new mailing address. Include a name, if different than your own.
Fees: Name or Physical Address Change – $5.00 Mailing Address Change Only – No Charge
Submit this form with payment to:Idaho Secretary of StatePO Box 83720Boise, ID 83720-0080
SELECT CHANGE(S): Name ChangeChange Physical Address Change Mailing Address
If yes, government agency name: Agency phone:
Yes NoAre you a city, county, or state government employee?Government employment: If you can truthfully answer "yes," there is no fee for filing this form.
Commission Number:
First Name: Middle Name or Initial (if used):Last Name: Suffix (Jr., Sr., ect.):CURRENT COMMISSION NAME :
Find your commission number at: http://www.sos.idaho.gov/NotarySearch/