INSTRUCTIONS FOR APPLYING TO RENEW NOTARY PUBLIC COMMISSION Effective January 2008 fee is 70 This appl

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INSTRUCTIONS FOR APPLYING TO RENEW NOTARY PUBLIC COMMISSION Effective January 2008 fee is 70 This appl Powered By Docstoc
					                        INSTRUCTIONS FOR APPLYING TO RENEW
                                NOTARY PUBLIC COMMISSION
                                 Effective January 2008 fee is $70
     This application is valid for all Ohio Residents. Once commissioned, Ohio notaries have
                                   jurisdiction throughout the state.
 A) The process for renewing a Notary Public Commission:
  Application and forms are mailed to the Columbus Bar Association with a check for $70
    (made payable to the Columbus Bar Association) or Credit Card payments may be made
    by faxing application forms and arrest record along with credit card information.
  You will receive your commission from the Secretary of State.
  Your commission must then be recorded with the Clerk of Courts before you can
    notarize any documents.


 B) For speediest processing, ensure that you have the following (4) forms completed and
 included with your $70 fee: (effective 1/08)
 1. Application for Notary Public Commission
 2. State form Page 1 - name, address and signature (must be completed by all persons)
 3. State Form Page 2 - part II if commission is expiring within 30 days (Part I is completed
     by Notary office)
 4. Arrest Record – Complete the top section only, up to but not including the Agency
     Requesting Record
  Incomplete renewal applications or applications missing forms or fees will not be processed.

Your $70 Notary Application fee covers application processing and test materials and administration.

         CREDIT CARD PAYMENTS                              NEED A REFRESHER? COME TO A
  Fax (4) forms from Box B along with Visa or
                                                                NOTARY SEMINAR!
           MasterCard Information to:
              Fax: 614-750-3102
           Attn: Notary Department                        Live Notary Seminars are held at the
                                                           Columbus Bar Association, once a
                                                           month on the date provided from 9-
                                                           11am. The seminar fee is $45 and
                                                           includes a review of all notary test
             CHECK PAYMENTS                                materials and current notary policies.
  Send (4) forms from Box B, along with a $70
  check payable to Columbus Bar Association
                                                       ONLINE NOTARY SEMINARS ONLY
                      to:
     COLUMBUS BAR ASSOCIATION
                                                       (Does not include test)
          NOTARY DEPARTMENT                             $45 @ www.OhioNotaryInfo.com
        175 S. THIRD ST. STE 1100
         COLUMBUS, OHIO 43215


                                                        Call the Columbus Bar Notary Department at
                                                         340-2031 with questions. We’re here to help!




       Columbus Bar Association       175 S. Third Street, Ste 1100      Columbus Ohio 43215
                 APPLICATION FOR RENEWAL NOTARY PUBLIC COMMISSION- $70 fee (effective 01/2008)

1.    Name of Applicant __________________________________________________________________(As listed on driver’s license)

      EMAIL ADDRESS ___________________________________________________________ Home Phone # _________________

2.    Home Address ____________________________________________________________________Zip Code_________________

3.    Date of Birth _______________________ 4. Employer _______________________________________________________________

5.    Employer Address __________________________________________________________Business Phone #________________________

6.    ARE YOU A RESIDENT OF FRANKLIN COUNTY? ____________________ FOR HOW LONG? ________________________

7.    Have you ever been a notary in Ohio? _____________________ Expiration date of former commission_______________________

8.    Have you ever had a commission revoked? ___________ Have you had an application rejected in the past five years? ____________
      (If you answered yes to either question above, please attach a statement of explanation.)

9.    Have you ever been convicted of or plead guilty to a crime resulting in a fine of $100 or more, or imprisonment? ________________
      (If yes, please attach a statement of explanation. Failure to include past criminal convictions may result in the denial of your application.)

10.   Have you ever been removed from office for reasons of moral turpitude, or had a business or professional license revoked? _______
      (If yes, please attach a statement of explanation.)

11.   (A) Have you ever sought but been refused a bond? ________ (If yes, please attach a statement of explanation.)

      (B) Have you ever had a claim made against the bond? ________ (If yes, please attach a statement of explanation.)

12.   As a consideration for the certificate of my qualifications to be Notary Public, I hereby represent and agree that as a Notary
      Public,
      (A) I will perform only such acts as a Notary Public is authorized to do by law.
      (B) I will not charge or accept an amount exceeding the legal fees for such services.
      (C) I will not draw, prepare, or draft for other persons, any legal papers such as deeds, notes, wills, mortgages, chattel
      mortgages, contracts, partnership agreements, and articles of incorporation, options, and leases, contracts for purchase or sale
      of real estate, escrow instruments, releases, mechanics liens, affidavits, bulk sales affidavits, or bills of sale.
      (D)I will not certify an affidavit of a person without administering the oath (or affirmation) to such person and then having
      him/her sign in my presence.
      (E) I will not certify the acknowledgment of any document in the absence of the person so acknowledging his/her
      signature.
      (F) I will not perform any notarial act after the date of expiration of my commission.
      (G) I will not notarize a document in which I have a financial or business interest.
      (H) I will not perform any notarial act without first obtaining satisfactory evidence of identification.

The section below must be signed and notarized:
In Witness Whereof, I have hereunto set my hand this ____________ day of ____________________, 20 ___________
      X ________________________________________________________________________________________________________
        (signature of applicant)
      State of Ohio, Franklin County, ss:
         _________________________________, being first duly sworn says that the responses stated in the above application are true.
         (printed name of applicant)
Sworn to before me and subscribed in my presence this ______________ day of _____________________, 20__________
         ________________________________________________________________________________________________________
         (signature of Notary Public)
         ________________________________________________________________________________________________________
         (printed name of Notary Public), Notary Public - State of Ohio
         My commission expires ________________________________

VISA/MASTERCARD/AMEX # _______________________________________________________________________________________
EXP. DATE ______________ CARD SECURITY CODE _________

NAME ON CARD _________________________________________ SIGNATURE ____________________________________________
CBA Processing Date: ______________________________________                      Amount Paid ______________               Renewal
                      Notary Commission Clerk
                      Ohio Secretary of State                                                    For the Information of Applicants
                      Tel. 614-644-4559
                                                                1. Section 147.02(B) of the Revised Code provides that, with respect to the certificate appearing on the
                                                                   reverse of this page, no judge or justice shall issue such a certificate until he or she is satisfied from
SOS 2001 (03/2009)                                                 personal knowledge that the applicant possesses the qualifications necessary to properly discharge
                                                                   the duties of the office of notary public, or until the applicant has passed an examination under such
                NOTARY PUBLIC                                      rules and regulations as the judge may prescribe. Because the practice varies among counties, it
               (Non-Attorney Only)                                 is recommended that an applicant for commission as a notary public begin by inquiring of the bar
        Application for the Appointment of                         association of his/her county or the clerk of common pleas court as to the procedure required by the
                      (Please print or type)                       common pleas court in his/her county.

Name: _________________________________________
                                                                2. A notary public whose term of office has expired before application for reappointment is made and who,
Name: _________________________________________                    knowing that the term has expired, has performed any notarial act after such expiration, is ineligible for
(Necessary only if name was different on previous commission)      reappointment. Therefore, an applicant who has held a commission, and who does not apply until after
                                                                   its expiration, must make and subscribe the affidavit on the back of this page before reappointment.
Residence Address (Required):
  Street:________________________________________
                                                                3. Fill in the blanks on front of this application with your full name and residence address, including
   City: _______________________ Zip: ______________               county. If the address is faulty or omitted, the commission cannot reach you.
   County: ________________ Contact #:______________

Mailing Address (if different):                                 4. R.C. 147.05 provides that, before entering upon the duties of the office, a notary public shall leave his/
  Street:________________________________________                  her commission (with the oath endorsed thereon) with the clerk of court of common pleas of the county
                                                                   in which the notary public resides. The clerk will record and index the commission.
   City: _______________________ Zip: ______________
   County: ________________ Contact #:______________
                                                                Powers and duties of a notary public are set forth in sections 147.01-147.371, inclusive, of the Ohio
                                                                Revised Code.
Written Signature (do not print):

X ________________________________________

Expiration of present (or former) Commission:

Date: _____________________________, 20__________

County: ________________________________________


                     OFFICE USE ONLY

   Commissioned _____________________________

   For five years
   Commencing______________________________
                PART I: TO BE COMPLETED BY ALL APPLICANTS (NEW OR RENEWAL)
 This certificate must be made by a justice of the Ohio Supreme Court, judge of an Ohio court of appeals, or judge
   of an Ohio court of common pleas. (Currently, justices of the supreme court decline to sign such certificates.)

The STATE OF OHIO, ____________________________________________ COUNTY, ss:

       It is hereby certified that _________________________________, an applicant for appointment to
the office of NOTARY PUBLIC for the STATE OF OHIO is of good moral character, that he/she is at least 18
years of age, a resident of ____________________________ County, State of Ohio; and that he/she possesses
sufficient qualifications and ability to properly discharge the duties of the office of notary public.

(Draw a line through whichever of the following statements does not apply.)
        - I am satisf ed from my personal knowledge that the applicant possesses the qualif cations necessary to
        properly discharge the off ce.
       - The applicant has passed an examination for the off ce under rules and regulations prescribed by the
       Court of which I am judge.

Date: ______________________, 20________, _____________________________ Judge of the

                      Court of Appeals of the _______________________________ District

                      Court of Common Pleas of ______________________________ County

__________________________________________________________________________________________

PART II: AFFIDAVIT – TO BE COMPLETED ONLY BY A NOTARY PUBLIC WHOSE OHIO
COMMISSION HAS EXPIRED.
(See item #2 on reverse side of this form.)
If the following affidavit is made before an officer having a seal, such officer must impress such seal below.

The STATE OF OHIO, ____________________________________________ COUNTY, ss:

        _________________________________, an applicant for appointment to the office of NOTARY
PUBLIC for the STATE OF OHIO, and whose term of office under his/her last appointment as a NOTARY
PUBLIC expired __________________, ______________, being duly sworn, says that he/she has not, knowing
that said term has expired, performed any notarial act since expiration of his/her term, and that he/she will not
perform any such act until reappointed and duly qualified.

                                                   _________________________________________________
                                                                   (Signature of Applicant)


Sworn to and subscribed in my presence, this ____________ day of ______________________, 20________.


                                                     ________________________________________________
                                                       Notary Public or Clerk of the Court of Common Pleas
I give the Columbus Bar Association permission to seek a copy of my arrest
record from the Franklin County Sheriff’s Office.    I do hereby release the
Franklin County Sheriff’s Office and all individuals connected therewith from
all liability.



DATE                               20     SIGNATURE

NAME                                           ALIAS/
               (PRINT OR TYPE IN FULL)         MAIDEN NAME

DATE OF BIRTH                            SEX          RACE

SOCIAL SECURITY NUMBER

AGENCY REQUESTING RECORD                 Columbus Bar Association

SIGNATURE OF AGENT MAKING REQUEST                     KQ

This is a copy of the arrest record on file at the Franklin County Sheriff’s
Office on the above named subject.   It is only a check by name and not by
fingerprints, and is not verified as to the true identity of the subject in
question.




               DATE                                          CHARGE




DISPOSITIONS
Municipal Court 645-8186                              BY
375 S High St.
                                                      DATE
Common Pleas Court 462-3650
369 S. High St.

SHR-RE-01-G-11/94
 Prepare for the Notary Public Exam!
Upcoming Dates                              Designed to prepare you for the official Ohio notary exam, or
                                            as a refresher course for those of you who have already been
September 18, 2010                          practicing as a notary, the Columbus Bar Association’s notary
October 9, 2010
November 13, 2010                           training seminar is a must! Course topics include:
December 11, 2010
                                            •   What do I need to know to pass the notary exam?
Time                                        •   What happens if I notarize something incorrectly?
All seminars begin at 9:00 a.m.             •   Where can I get into trouble?
Pre-registration is not required.
                                            •   What fees can I charge for notarial acts?
The course lasts approximately one          •   Where does an Ohio notary have jurisdiction?
hour, and the official notary exam          •   How do I establish another person’s identity?
will be given immediately after the
seminar.                                    •   How do I issue an oath?
                                            •   What is the difference between an acknowledgement
Cost                                            and an affidavit?
$45.00 for seminar registration
                                            •   You will also receive course materials containing
fee only; $115.00 for seminar                   helpful examples and a glossary of notary terms
registration fee and notary
application fee (for new and
renewing notary applicants).
                                            Presented by:
Location                                    Judge Charles A. Schneider
                                            Franklin County Common Pleas Court
Columbus Bar Association
175 S. 3rd St., Suite 1100                            You may also take this course online!
Columbus, OH 43215                                    Visit our website at www.peoplesbar.org.




        Notary Public Seminar & Test Registration Form
 Name: ___________________________________________________ Telephone # ____________________________

 Address: _________________________________________ City/State/Zip: ____________________________________

 Total Enclosed $______________________________          Visa/Mastercard # ____________________________________

 Exp. Date __________________          Authorized Signature ___________________________________________________

 Register me for:
                      Sept. 18, 2010       October 9, 2010       November 13,2010      December 11, 2010

Return registration form with payment to:

Columbus Bar Association, 175 S. Third St., Suite 1100, Columbus, OH 43215

FAX CREDIT CARD ORDERS TO 614-750-3102
                                                                          


 ota y S rve
No ary Sur ey
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                        
   This survey is optional to help us better serve
                                                 e you.                   
  
 1. I would like to learn more about notarizing m     mortgage 
       documeents                                                             yes  no       
 2. I would like to learn more about auto titles: understanding                         
       the docuument, poss               ssues and red
                            sible fraud is             d flags.               yes  n no     
 3. I am stud dying to beco  ome a notar ry because:                          
              
                        Wo ork Requirem ment                                
              
                        Personal Busin ness Opportu  unities                
              
                        Enhancing qua  alifications                         
              
                        Other (please specify)                                         
                          _____________  ___________   __________  ___________  _________
                          _____________  ___________   __________  ___________  _________
  
 4. Which of   f the following seminars  s interest youu on a local level:   
              
                          mely notary topics
                          Tim                                                 
              
                        Seminars on sp              tice areas (e.g. real estat
                                          pecific pract                         te)      
              
                        Other (please specify)                                                 
                          _____________  ___________   __________  ___________  _________
                          _____________  ___________   __________  ___________  _________
  
 5. I am inteerested in receiving infor   rmation abo out:
              
                        Neewsletters                                        
              
                        Disscount on ed ducational mmaterials               
              
                          & O insuranc
                          E &            ce                                   
              
                        Em             egarding Not
                            mail alerts re            tary law chan nges   
              
                        Disscounts on NNotary supp lies                     
              
                        Neetworking op pportunities                         
              
                        Other (please specify)                                                 
                          _____________  ___________   __________  ___________  _________
                          _____________  ___________   __________  ___________  _________
  
 6. Do you currently belong to the N     National Not tary Associattion?      yes  no       
 7. Do you currently belong to a loca     al notary asssociation?             yes  no       
                                                                              
 
 Please send  d me more in   nformation a about joininng the Ohio NNotary Assoc ciation.
                                                                          
 Name ________________ ___________                                        
                                                                                                 
 Address:                                                                            

 Email:                                                                              
                  Revised Notary Handbook

                             The must-have Notary Handbook features:
                                • Ohio Revised Code amended notary law §147.01 and 147.37
                                • State of Ohio auto title forms
                                • Allowable fees charged by a notary public
                                • Notarial journal conveniently located in back of the Handbook




Payment Information
                                                 # Handbooks______ X          $9.95      $

                                                 Tax:                         6.75%      $

                                                 Total:                                  $

Method of payment:      Check (payable to CBA)          Visa           MasterCard

Credit Card Number                                          Expiration Date
Name on Card                                                Authorized Signature


Shipping Information                                                                  FREE SHIPPING!
Name

Company Name (must include if shipped to a business address)

Street Address

City, State Zip

Email address                                                           Daytime Phone Number
                                  Price effective 10-2009

                Return this form with payment to Columbus Bar Association,
                    175 S. Third Street, Ste.1100, Columbus, OH 43215.
NOTARY STAMPS AND SUPPLIES ORDER FORM
(complete and return the reverse side of this order form, or order your stamps and supplies online at www.peoplesbar.org)

Stamps and Embossers
                    $79.95 DELUXE PACKAGE - EVERYTHING YOU NEED!                             E   $21.95 NOTARY EMBOSSER
               The Deluxe Package includes a hand embosser (crimps a raised                 Package E includes a notary embosser which crimps a
               seal on the paper), a self-inking stamp (includes your name,
               commission expiration date, and seal), replacement ink for stamp,
                                                                                            raised seal on paper of the State of Ohio.
               3 notarial language stamps (Affidavit/Jurat, Acknowledgement,
               Non-Attorney), and the Handbook. All items purchased separately
               would cost $146.65 (savings of $66.70).

               A    $34.95 EMBOSSER, RUBBER STAMP AND INK PAD                                F   $24.95 AFFADAVIT/JURAT SELF-INKING STAMP AND INK
               Package A includes a hand embosser (crimps a raised                          Package F includes an “Affadavit/Jurat” self-inking stamp
               seal on the paper), rubber stamp (includes your name                         and a bottle of re-inking ink.
               and commission expiration date), and stamp pad.


               B    $34.95 SELF-INKING STAMP WITH SEAL AND INK                               G   $24.95 ACKNOWLEDGEMENT SELF-INKING STAMP AND INK
               Package B includes a self-inking stamp (includes your                        Package G includes an “Acknowledgment” self-inking
               name, commission expiration date, and seal) and                              stamp and a bottle of re-inking ink.
               replacement ink for stamp. Clean, compact, easy to use.


               VIP B $47.95 PRE-INKED STAMP WITH SEAL AND INK                                H   $24.95 “NOT AN ATTORNEY” SELF-INKING STAMP AND INK
               Package VIP B includes a pre-inked, slim pocket stamp                        Package H includes a a “Not an Attorney” self-inking
               (includes your name, commission expiration date,                             stamp and a bottle of re-inking ink.
               and seal) and a bottle of re-inking ink.


               D    $19.95 RUBBER STAMP (NO SEAL) AND INK PAD                                I   $49.95 SET OF 3 SELF-INKING STAMPS AND INK
               Package D includes a rubber stamp with your name                             Package I includes the Affadavit/Jurat, Acknowledgment,
               and commission expiration date, and stamp pad.                               and “Not an Attorney” stamps and a bottle of re-inking ink.



Stamp Pads and Replacement Ink
                J   $5.95 FELT STAMP PAD                                                     L   $4.95 RE-INKING INK FOR SELF-INKING STAMPS
               Package J includes a high-quality felt stamp pad.                            Package L includes a a bottle of re-inking ink.
               (available in black or blue ink)                                             (available in black or blue ink)


               K    $4.95 REPLACEMENT PAD                                                   M    $5.95 RE-INKING INK FOR PRE-INKED STAMPS
               Package K includes a replacement pad for Package B.                          Package M includes a bottle of re-inking ink for Package VIP B.
               (available in black or blue ink)                                             (available in black or blue ink)



Other Notary Supplies
               C    $9.95 NOTARY HANDBOOK AND JOURNAL                                       S    $27.95 GOLD & BLACK NAME PLATE w/WALNUT HOLDER
               Package C includes a 45-page Notary Handbook and                             Package S includes a a brushed gold/black laser engraved
               Journal. Small and compact, it is perfect as a quick                         plate with an 8” solid walnut desk block. Personalized with
               reference guide for the most frequently asked questions.                     “YOUR NAME” and “NOTARY PUBLIC.”


               Q    $12.95 BLACK & WHITE PLATE w/ACRYLIC HOLDER                             T    $9.95 BLACK & WHITE OR GOLD & BLACK - PLATE ONLY
               Package Q includes a black/white laser engraved plate                        Package T includes a 2” x 8” laser engraved plate with the
               with the words “NOTARY PUBLIC” and an 8” polished                            words “NOTARY PUBLIC.” It comes with double-faced tape
               acrylic desk holder.                                                         for easy mounting on a wall, door or window.
                                                                                            (available in either black/white or gold/black)

               R    $21.95 BLACK & WHITE NAME PLATE w/SILVER HOLDER
                                                                                   Columbus Bar Association
               Package R includes a black/white laser engraved plate
               with an 8” anodized aluminum desk holder. Personalized
               with “YOUR NAME” and “NOTARY PUBLIC.”
                                                                                   www.cbalaw.org
NOTARY STAMPS AND SUPPLIES ORDER FORM
>> Information to Appear on Stamp
Name (as it appears on your commission)
NEW expiration date (as it appears on your commission)*
* It is recommended that you mail your order form AFTER you have received your commission certificate from the state and verified the commencement date. The
Columbus Bar Association and its stamp supplier are not responsible for incorrect or incomplete expiration dates written on the order form. If you are unsure of your
expiration date, visit www.sos.oh.us.gov or contact the Notary Department at 614/340.2031.


>> Packages
q DELUXE Package - Everything You Need! $79.95                                                    q Package I - Set of 3 Self-Inking Stamps and Ink $49.95
q Package A - Embosser, Rubber Stamp and Ink Pad $34.95                                           q Package J - Felt Stamp Pad $5.95
q Package B - Self-Inking Stamp with Seal and Ink $34.95                                          q Package K - Replacement Pad $4.95
q Package VIP B - Pre-Inked Stamp with Seal and Ink $47.95                                        q Package L - Re-Inking Ink $4.95
q Package C - Notary Handbook and Journal $9.95                                                   q Package M - Re-Inking Ink $5.95
q Package D - Rubber Stamp (No Seal) and Ink Pad $19.95                                           q Package Q - Black & White Plate w/Acrylic Holder $12.95
q Package E - Notary Embosser $21.95                                                              q Package R - Black & White Name Plate w/Silver Holder $21.95
q Package F - Affidavit/Jurat Self-Inking Stamp and Ink $24.95                                    q Package S - Gold & Black Name Plate w/Walnut Holder $27.95
q Package G - Acknowledgement Self-Inking Stamp and Ink $24.95                                    q Package T - Plate Only (q black/white q gold/black) $9.95
q Package H - “Not an Attorney” Self-Inking Stamp and Ink $24.95

  Cost of Packages Ordered                          $__________                                   >> Choose Ink Color: (if applicable)
                 Sales Tax (6.75%)                  $__________                                   q Black Ink
                                                                                                  q Blue Ink
       TOTAL AMOUNT DUE                             $__________


>> Payment Information
Method of payment:                     q Check (payable to CBA) q Cash q Visa q MasterCard q American Express


Credit Card #                                                                                   Expiration Date


Name on Card                                                                                    Authorized Signature


>> Shipping Information (shipping is free!)

Name


Company Name (must include if shipped to a business address)


Address                                                                                         City/State/Zip


Email Address                                                                                   Daytime Phone #


Please return this form to:
Columbus Bar Association, 175 S. Third St., Suite 1100, Columbus, OH 43215
or fax to 614/750.3102
  It wasn’t the notary’s
   fault but it cost him
     $11,500 anyway.
It was a routine transaction, and there was
no way the notary could have known the
signatures were forgeries. But they were.                    RLI requires no deductible…
And, in the eyes of the court, the notary was         That’s exactly why we’re here. We protect
at fault. This time the penalty was $8,000 in         notaries…beginning with the very first dollar
damages, $3,500 in court costs. Unfair?               in damages. In other words, we require no
Sure. But for notaries public in a litigious          deductible. We pay every dollar of damages
society like ours, it’s just part of the territory.   and legal costs right up to the policy limit –
                                                      and that may mean up to $30,000. So,
                                                      should you ever be sued, you can relax –
                                                      the chances are you’ll never face an out of
 Fortunately, We’ve got                               pocket expense.
  the territory covered.                                        No lengthy exclusions…

No one can say whether you’ll ever be faced
                                                      Equally reassuring, you’ll find our policies
                                                      are not watered down with lengthy
                                                                                                          NOTARY
with a situation like the one just described.
But, as a notary you are vulnerable. And,
                                                      exclusions. In fact, we pride ourselves on
                                                      offering the most comprehensive coverage
                                                                                                       PUBLIC ERRORS
with major judgments against notaries now
reaching tens of thousands of dollars, it’s
important to have someone in your corner
                                                      in the industry. Our job is to protect you in
                                                      case of claim…freeing you to do your job.             AND
should you find yourself faced with a lawsuit.                    We pay defense costs…
                                                      Having this kind of protection is more
                                                                                                         OMISSIONS
     DON’T WAIT!
                                                      important than ever before because lawsuits
                                                      against notaries are becoming more
                                                                                                        INSURANCE
                                                      common every day. Forged, incomplete, or
 PROTECT YOURSELF                                     otherwise defective signatures all can cast
                                                      doubt on the validity or date of a document.
    WITH NOTARY                                       And when that happens, someone is to
                                                      blame. Too often these days, the blame is
    ERRORS AND                                        placed on you – the notary. Worse yet, even
                                                      if the suit is not valid you may not be spared
     OMISSIONS                                        the need to protect yourself from
  INSURANCE FROM                                      prosecution. And, without coverage you’ll
                                                      have to pay these defense costs yourself.

                                                      Make sure this doesn’t happen to you. Your
                                                      agent can get RLI’s affordable coverage for
                 TODAY!                               you. Call today.
  Individual Notary                          Individual E&O Limits                                             Application
Public E&O Insurance                          and Term Premiums                                  Individual Policy

Pays court costs, attorney fees, etc. – up    $5,000.00   ...   $37.50   /   5 -year   premium   Name
to one half the face amount of the policy.
                                             $10,000.00   ...   $62.50   /   5 -year   premium   Address
Pays judgment up to the face amount of
the policy.                                  $25,000.00   ...   $93.75   /   5 -year   premium   City

No deductible.                                            ...            /    -year premium      State                              Zip

Written to coincide with Notary’s                                                                Date of Commission
commission.
                                                                                                 Amount of Coverage $
                                             Blanket E&O Limits
Blanket Notary Public                        and Term Premiums                                   Blanket Policy
   E&O Insurance                             $5,000.00    ...   $7.50    /per year per Notary    Employer’s Name
Employers are covered at no additional       $10,000.00   ...   $12.50   /per year per Notary    Address
charge.
                                             $25,000.00   ...   $18.75   /per year per Notary    City
No need to advise of changes during
policy period.                                            ...            /per year per Notary    State                              Zip
Additional notaries are automatically                                                            Number of Notaries
covered.
                                                                                                 Amount of Coverage $

Notary E&O Benefits                                                                                     Check here if this has been previously faxed.

No deductible.                               A.M. Best’s rating: A+, Superior.                   Agency Name
                                                                                                 CBS Agency
Covers defense costs.                        Standard & Poor’s rating: A+.
                                                                                                 Address
Protects against errors and omissions.       Year after year RLI has appeared in the             Street & Number
                                             Ward’s 50, a select group of top                    175 Sourth Third Street, Suite 1100
Employers covered under blanket policy       insurance companies based on financial
at no additional charge.                                                                         City                          State          Zip
                                             safety, consistency and performance.
                                                                                                 Columbus                      OH             43215
Additional notaries covered automatically    24 hour turn around time on all new                 Phone Number                         Agency Code
under blanket policy.                        business.                                           (614) 340-2076                       47310

				
DOCUMENT INFO
Description: Notary State of Ohio Renewal Form document sample