Free 19355 12-07.xft - North Dakota



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COMPLETE, PRINT, SIGN AND MAIL NOTARY BOND SECRETARY OF STATE SFN 19355 (12-07) INSTRUCTIONS: ___________________________________ BOND # 1. For reference, see North Dakota Century Code, Chapter 44-06. 2. In compliance with the Federal Privacy Act of 1974, the disclosure of the social security number on this form is voluntary. It is not disclosed to the public. The numbers are used by the Secretary of State to maintain accurate notary files. Therefore, while voluntary disclosure is requested, failure to do so will not invalidate this notary bond. 3. Please type or print the requested information. You must sign the form in the presence of a notary public. 4. This six year notary bond must be in the amount of $7,500.00. The bond may be obtained from any surety company of your choice or from one or two personal sureties who are approved by the Se

COMPLETE, PRINT, SIGN AND MAIL
NOTARY BOND
SECRETARY OF STATE
SFN 19355 (12-07) INSTRUCTIONS: ___________________________________ BOND #

1. For reference, see North Dakota Century Code, Chapter 44-06. 2. In compliance with the Federal Privacy Act of 1974, the disclosure of the social security number on this form is voluntary. It is not disclosed to the public. The numbers are used by the Secretary of State to maintain accurate notary files. Therefore, while voluntary disclosure is requested, failure to do so will not invalidate this notary bond. 3. Please type or print the requested information. You must sign the form in the presence of a notary public. 4. This six year notary bond must be in the amount of $7,500.00. The bond may be obtained from any surety company of your choice or from one or two personal sureties who are approved by the Secretary of State. The personal surety/sureties must be residents of North Dakota, not your spouse, and must have the financial ability to be answerable for any debt, liability, or default that may be incurred as you carry out your duties as a Notary Public. 5. The applicant and a representative of the surety company (or the personal sureties) must sign this form before a Notary Public other than the applicant. Legal Name of Applicant Residential address of Applicant Name of Surety Company or Personal Surety (#1) Residential address Name of Personal Surety (#2) Residential address City City City Social Security # State Zip Code

Secretary of State State of North Dakota 600 E Boulevard Ave Dept 108 Bismarck ND 58505-0500 Telephone 701-328-2901 Toll Free 800-352-0867 Ext 82901 Fax 701-328-1690

Social Security # State Zip Code

Social Security # State Zip Code

ACKNOWLEDGEMENT OF PRINCIPAL (APPLICANT)
I, the undersigned principal (applicant) do hereby hold and firmly bind myself unto the people of the State of North Dakota in the penal sum of SEVEN THOUSAND FIVE HUNDRED DOLLARS for the payment of which I bind myself, my heirs, executors, administrators and assigns, firmly by these presents. The condition of the foregoing obligation is for my appointment as a Notary Public within and for the State of North Dakota. If I perform the duties of Notary Public according to the law, then this obligation becomes null and void, otherwise it remains in full force and effect.

ACKNOWLEDGEMENT OF SURETY/PERSONAL SURETY
As a representative of the above named surety company, or as an individual personal surety, I hereby acknowledge that we are held and firmly bound unto the people of the State of North Dakota in the penal sum of SEVEN THOUSAND FIVE HUNDRED DOLLARS for the payment of which is binding on our company or ourselves as a personal surety, our heirs, executors, administrators and assigns, firmly by these presents. The condition of the foregoing obligation is for the appointment of the principal (applicant) as a Notary Public within and for the State of North Dakota. (NOTE: If attorney-in-fact executes the bond on behalf of a surety company, a proper authority of such attorney-in-fact must be provided.)

Surety Company or Personal Surety (#1) Signature

Date

Applicant Signature

Date
Personal Surety (#2) Signature Date

State of __________________ County of ________________ The foregoing instrument was acknowledged before me this _________ day of _________________, 20 ______

State of __________________ County of ________________ The foregoing instrument was acknowledged before me this _________ day of __________, 20 _____ by ________________________________________
Name of Surety Company or Personal Surety (#1)

by __________________________________________________ Applicant Name Notary Public My Commission expires: _________________________

and ___________________________________________________________
Name of Personal Surety (#2)

Notary Public My Commission expires: __________________________

(Notary Seal /Stamp)

(Notary Seal /Stamp) If a bond is furnished by a foreign surety company, resident agent may sign here. Resident Agent Signature

File Size: 72.2 kB
Pages: 1
Date: May 14, 2008
File Format: PDF
State: North Dakota
Category: Notary
Author: rbernard
Word Count: 606 Words, 4,052 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.state.nd.us/eforms/Doc/sfn19355.pdf