Please follow the instructions carefully and fill out all fields, or your application may be rejected. If you need additional assistance, call the NNA Application Hotline at 1-888-867-6827 (M-F, 9:00 a.m. - 8:00 p.m. ET).
Both sides and all fields are required. Please hover over each highlighted letter for details on each field.
a b c d e f g h i j
A. Check only one box – New appointment or Reappointment.
B. New notaries leave the boxes blank. Renewing notaries, complete as much information as possible. If unsure of the information, our Application Hotline (1-888-867-6827) or Department of State may be able to help.
C. Part I = Name as you want your Notary Name to appear. This name will be what you sign with for the next 4 years. Do NOT use first initial, middle initial, last name; nicknames are not acceptable, and you cannot use suffix’s such as M.D., Ph.D, J.D., and Esq. (Sr., Jr., III, IV are acceptable suffixes).
D. SSN – Department of State requires this information, cannot leave this blank or enter N/A.
E. Email address – will be used for official use only by the Department of State, but it is optional and you can enter N/A if you choose to not provide your email address.
F. Employer/Business where Notary commission will be used section is the address that will be used as your “office of record” for official correspondence from the Dept. of State, including your letter of appointment and your bond. If you are a resident of PA, and you want to use your home address as your “office of record”, enter N/A in this section. For non-PA residents, a business address located in PA must be used. P.O. Box alone is not sufficient for “office of record”, a physical street address, city, state & zip must be entered. Telephone number is required.
G. Part II: Check mark or X is sufficient to answer the 4 questions.
H. If you are required to complete a pre-approved 3-hour Notary education course, check Yes in the box, attach a copy of your proof of education certificate and keep your original for your records. If you were a Notary Public with an active commission on July 1, 2003, you are exempt from education; check No in the box.
I. In the last 5 years, do any of these apply to you? If Yes to any or all of these questions, attach appropriate supporting documents. You are not required to report violations such as moving violations and parking tickets.
J. Must sign and date your application. Your signature name must match the name you entered in Part 1 of this application.
K. *Be sure to send your proof of completion certificate from your required education course along with any other required documents from Part II, with your application to the NNA.
L. *If you purchased a package with the NNA, the $40 state fee is included and you do not need to send another fee with your application.
M. *After the NNA reviews your application, we will forward your paperwork and state fee to the Department of State.