Arkansas Notary Public Change of Information Form

Should there be changes in a notary public’s personal information, s/he must notify the Secretary of State’s office by submitting an accomplished copy of this form to the _____________.Download

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To  change  the personal  information  on file  with  the Secretary  of State’ s of fice,  please  complete
the  form  as it applies  to you.  If your  name  has changed,  please attach a certified  copy of the  doc-
ument  providing  the change,  i.e., marriage  certificate,  divorce decree or court  order.
PLEASE  TYPE OR PRINT
Name,  address  and county  currently  registered  in as  a notary:
Name:  _______________________________
Address:  _____________________________________________________________________
________________________________________________________________________\
_____
County:  ________________________________
Commission  date: ________________________
Name,  address  and county  changes  to be  made:
Name:  __________________________________
Physical  address:   _____________________________________________________________
________________________________________________________________________\
_____
County:  ____________________ Phone: Home _______________  Work  _______________
Address  to which  certificate  is to  be  sent:  ___________________________________________
________________________________________________________________________\
_____
I understand that knowingly signing a false document with the intent to \
file with the  Arkansas Secretary of
State  is a Class  C misdemeanor  and is punishable  by a fine  up to $100.00  and/or imprisonment  up to 30
days.
Notary Signature Date	
Change of Personal  Information	
for Notaries  Public	
Arkansas Secretary of State
M	ark	M	artin	
Business & Commercial Services, 250 \bictory Buil\fing, 1401 W. Capitol, Little Rock	
State Capitol • Little Rock, Arkansas 722011094
5016823409 • www.sos.arkansas.gov