Wyoming Notary Public Commission Application
(W.S. 32-1-107) Instructions: Fill in all blanks, using "NA" if not applicable. Type or print clearly.
1. Commission Name Style (type or print name to exactly match signature below.) 2. County of Residence
-- Select One -3. Gender 4. Last Name 5. First Name 6. Middle Name
8. City 9. Zip Code 10. Home Phone
7. Residential Address (street/route)
11. Mailing Address (where notary information will be mailed)
13. Zip Code
14. Place of Employment (name & address)
16. Zip Code
17. Business Phone
18. I am applying for:
a new commission; or a renewal of my current commission. My current commission expiration date is: ___________________
19. Have you ever been a Wyoming notary?
Yes, under the name of ______________________________ in ________________________ County. No. Certification: please read, sign, and date.
I certify that I am 18 years of age or older, able to read and write the English language, and an actual resident of the state of Wyoming and of the County for which I am making application. I further certify that I understand the duties and responsibilities imposed on notaries public under Wyoming law and understand that breach of said responsibility may result in criminal penalties including imprisonment.
Signature of applicant (must match item #1 above) Filing Fee: $30.00 (make checks payable to "Secretary of State") Return application and filing fee to:
Notary Officer Secretary of State's Office State Capitol Building, 200 West 24th Street Cheyenne, WY 82002-0020 Ph. 307.777.5335