Columbus Bar Association 175 S. Third Street, Ste 1100 Columbus Ohio 43215

INSTRUCTIONS FOR APPLYING TO RENEW NOTARY PUBLIC COMMISSION

Effective July 2013, fee is $80 This application is valid for all Franklin County, Ohio Residents.

Once commissioned, all Ohio notaries have jurisdiction throughout the state.

Your $80 Notary Application fee covers application processing and administration.

B) For speediest processing, ensure that you have the following 3 forms completed andincluded with your fee:

1. Application for Notary Public Commission2. Jon Husted, Ohio Secretary of State Form - name, address and signature (must be completed by all persons)3. Background Check Authorization – Complete and sign the top section only, up to but not including the Agency

Requesting Record. This authorizes the CBA to conduct a background check.

Incomplete renewal applications or applications with missing forms or fees will not be processed.

A) The process for renewing a Notary Public Commission: Application and forms are mailed to the Columbus Bar Association with a check for $80

(made payable to the Columbus Bar Association) or Credit Card payments may be madeby 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 in the county in which

you live before you can notarize any documents.

CHECK PAYMENTS Send the 3 forms from Box B, along with

a check for $80 payable to Columbus Bar Association to:

COLUMBUS BAR ASSOCIATION NOTARY DEPARTMENT

175 S. THIRD ST., SUITE 1100 COLUMBUS, OHIO 43215

CREDIT CARD PAYMENTS Fax the 3 forms from Box B along with Visa, MasterCard, AmEx or Discover number to:

Fax: 614-750-3102 Email: notary@cbalaw.org

NEED A REFRESHER? COME TO A NOTARY SEMINAR!

Live Notary Seminars are held at theColumbus Bar Association one Saturdayevery month from 9:00-11:00am. Theseminar fee is $45 and includes a reviewof all notary test materials and currentnotary policies.

ONLINE NOTARY SEMINARS ONLY (Does not include test) $45 @ www.eondirect.com/CBA

Call the Columbus Bar Association Notary Department at 614-340-2031 with questions.

We’re here to help!

APPLICATION FOR RENEWAL NOTARY PUBLIC COMMISSION- $80 fee (effective 07/2013)

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 NotaryPublic,(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, chattelmortgages, contracts, partnership agreements, and articles of incorporation, options, and leases, contracts for purchase or saleof 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 havinghim/her sign in my presence.(E) I will not certify the acknowledgment of any document in the absence of the person so acknowledging his/hersignature.(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 ________________________________

CREDIT CARD # ________________________________________________________________________________________

EXP. DATE ________ CARD SECURITY CODE ________ BILLING ADDRESS __________________ BILLING ZIP CODE _________

NAME ON CARD _________________________________________ SIGNATURE _____________________________________________

CBA Processing Date: ______________________________________ Amount Paid ______________ Renewal

Last Revised: 02/15/2018Form 2001

Application for Notary Public (Non Attorney)

Name

Residence Address (Required):

Street City

ZIP Code

Name as it appears on previous commission (if applicable)

Commission Number

County

Expiration Date of Present Commission (MM/DD/YYYY)

If renewal is checked above, please provide expiration date of present commission (MM/DD/YYY), commission number and county:

This application must be accompanied by a certificate from a judge described in Ohio Revised Code Section 147.02.

Page two of this form may be completed to meet this requirement. To obtain the judge’s signature you may need to

complete additional requirements such as a class, test or background check as required by the county in which you

reside. Please contact your local bar association or county for additional information. Contact information for each county

is provided at www.sos.state.oh.us/notary/frequently-asked-questions-about-notaries/.

Reminder: Ohio Revised Code section 147.05 provides that, before entering upon the duties of the office, a notary public

shall present his/her commission to be recorded (with the oath endorsed therein) with the clerk of court of common pleas

of the county in which the notary resides.

Signature X______________________________________________________________________________

County

Form 2001 Prescribed by:

State

New Application Renewal

BACKGROUND CHECK AUTHORIZATION

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.

SIGNATURE _________________________________________________________

(application cannot be processed without a signature)

DATE , 20 __

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 SC____

This is a copy of the arrest record on file from 1987 to the present at the Franklin County Sheriff’s Office on the above named subject. It is checked by name only, 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 5252-3650

345 S. High St.

SHR-RE-01-G-11/94

Price effective 10-2009

Return this form with payment to Columbus Bar Association,175 S. Third Street, Ste.1100, Columbus, OH 43215.

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

Credit Card Number Expiration Date

Name on Card Authorized Signature

Payment Information# Handbooks______ X $9.95 $

Tax: 7.5% $

Total: $

Name

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

Street Address

City, State Zip

Daytime Phone Number

Shipping Information FREE SHIPPING!

Email address

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

Complete and return the reverse side of this order form, or order your stamps and supplies online at www.cbalaw.org.

Stamp Pads and Replacement InkJ $7.95 FELT STAMP PAD

Package J includes a high-quality felt stamp pad.(available in black or blue ink)

K $6.95 REPLACEMENT PADPackage K includes a replacement pad for Package B.(available in black or blue ink)

L $5.95 RE-INKING INK FOR SELF-INKING STAMPSPackage L includes a a bottle of re-inking ink.(available in black or blue ink)

M $8.95 RE-INKING INK FOR PRE-INKED STAMPSPackage M includes a bottle of re-inking ink for Package VIP B.(available in black or blue ink)

Notary Stamps and Supplies Order Form

Stamps and Embossers

A

B

B

N

$83.95 DELUXE PACKAGE - EVERYTHING YOU NEED!

$39.95 EMBOSSER, RUBBER STAMP AND INK PAD

$34.95 SELF-INKING STAMP WITH SEAL AND INK

$47.95 PRE-INKED STAMP WITH SEAL AND INK

$15.50 SELF-INKING STAMP (NO SEAL)

E $24.95 NOTARY EMBOSSER

The Deluxe Package includes a hand embosser (crimps a raised seal on the paper), a self-inking stamp (includes your name, commission expiration date, and seal), replacement ink for stamp, 3 notarial language stamps (Affidavit/Jurat, Acknowledgement, Non-Attorney), and the Handbook.

Package A includes a hand embosser (crimps a raisedseal on the paper), rubber stamp (includes your nameand commission expiration date), and stamp pad.

Package B includes a self-inking stamp (includes yourname, commission expiration date, and seal) and replacement ink for stamp. Clean, compact, easy to use.

Package VIP B includes a pre-inked, slim pocket stamp (includes your name, commission expiration date,and seal) and a bottle of re-inking ink.

Package N includes a self-inking stamp with your name and commission expiration date.

I $49.95 SET OF 3 SELF-INKING STAMPS AND INKPackage I includes the Affadavit/Jurat, Acknowledgment, and “Not an Attorney” stamps and a bottle of re-inking ink.

O $25.95 ROUND SEAL SELF-INKING STAMPPackage O includes a round self-inking stamp with the seal, your name and commission expiration date.

H $24.95 “NOT AN ATTORNEY” SELF-INKING STAMP AND INKPackage H includes a a “Not an Attorney” self-inkingstamp and a bottle of re-inking ink.

G $24.95 ACKNOWLEDGEMENT SELF-INKING STAMP AND INKPackage G includes an “Acknowledgment” self-inking stamp and a bottle of re-inking ink.

F $24.95 AFFADAVIT/JURAT SELF-INKING STAMP AND INKPackage F includes an “Affadavit/Jurat” self-inking stamp and a bottle of re-inking ink.

Package E includes a notary embosser which crimps a raised seal on paper of the State of Ohio.

VIP

SAMPLE

SAMPLE

SAMPLE

SAMPLE

SAMPLE

SAMPLE

D $22.95 RUBBER STAMP (NO SEAL) AND INK PADPackage D includes a rubber stamp with your nameand commission expiration date, and stamp pad.

Other Notary SuppliesC $9.95 NOTARY HANDBOOK AND JOURNAL

Package C includes a 45-page Notary Handbook and Journal. Small and compact, it is perfect as a quick reference guide for the most frequently asked questions.

T $9.95 BLACK & WHITE OR GOLD & BLACK - PLATE ONLYPackage T includes a 2” x 8” laser engraved plate with the words “NOTARY PUBLIC.” It comes with double-faced tape for easy mounting on a wall, door or window.(available in either black/white or gold/black)

Q $12.95 BLACK & WHITE PLATE w/ACRYLIC HOLDER Package Q includes a black/white laser engraved plate with the words “NOTARY PUBLIC” and an 8” polishedacrylic desk holder.

R $21.95 BLACK & WHITE NAME PLATE w/SILVER HOLDERPackage R includes a black/white laser engraved plate with an 8” anodized aluminum desk holder. Personalized with “YOUR NAME” and “NOTARY PUBLIC.”

S $27.95 GOLD & BLACK NAME PLATE w/WALNUT HOLDERPackage S includes a a brushed gold/black laser engraved plate with an 8” solid walnut desk block. Personalized with “YOUR NAME” and “NOTARY PUBLIC.”

Columbus Bar Associationwww.cbalaw.org

Notary Stamps and Supplies Order Form

Please return this form to:Columbus Bar Association, 175 S. Third St., Suite 1100, Columbus, OH 43215, or fax to (614) 221-4850.

Columbus Bar Association

Information to Appear on StampName (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 Columbus Bar Association at (614) 340-2031.

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q DELUXE Package - Everything You Need! $83.95q Package A - Embosser, Rubber Stamp and Ink Pad $39.95q Package B - Self-Inking Stamp with Seal and Ink $34.95q Package VIP B - Pre-Inked Stamp with Seal and Ink $47.95q Package C - Notary Handbook and Journal $9.95q Package D - Rubber Stamp (No Seal) and Ink Pad $22.95q Package E - Notary Embosser $24.95q Package F - Affidavit/Jurat Self-Inking Stamp and Ink $24.95q Package G - Acknowledgement Self-Inking Stamp and Ink $24.95q Package H - “Not an Attorney” Self-Inking Stamp and Ink $24.95

q Package I - Set of 3 Self-Inking Stamps and Ink $49.95q Package J - Felt Stamp Pad $7.95q Package K - Replacement Pad $6.95q Package L - Re-Inking Ink $5.95q Package M - Re-Inking Ink $8.95q Package N - Self-Inking Stamp (No Seal) $15.50q Package O - Round Seal Self-Inking Stamp $25.95q Package Q - Black & White Plate w/Acrylic Holder $12.95q Package R - Black & White Name Plate w/Silver Holder $21.95q Package S - Gold & Black Name Plate w/Walnut Holder $27.95q Package T - Plate Only (q black/white q gold/black) $9.95

Packages

Cost of Packages Ordered $__________ Shipping $ 3.50 Subtotal $__________ Sales Tax (7.5%) $__________ TOTAL AMOUNT DUE $__________

>> Choose Ink Color: (if applicable)

q Black Inkq Blue Ink

2

Payment InformationMethod of payment: q Check (payable to Columbus Bar Association) q Cash q Visa q MasterCard q AmEx q Discover

Credit Card # Expiration Date Card Security Code

Billing Address Billing Zip Code

Name on Card Authorized Signature

3

Shipping Information

Name

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

Address City/State/Zip

Email Address Daytime Phone #

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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. And, in the eyes of the court, the

notary was at fault. This time the penalty was $8,000 in damages and $3,500

in court costs. Unfair? Sure. But, for a notary public in a litigious society like

ours, it’s just part of the territory.

Fortunately, we’ve got the terrItory covered.

No one can say whether you’ll ever be faced with a situation like the one just

described. But, as a notary you are vulnerable. And, with major judgments

against notaries now reaching tens of thousands of dollars, it’s important to

have someone in your corner should you find yourself faced with a lawsuit.

rlI requIres no deductIbleThat’s exactly why we’re here. We protect notaries beginning with the very first

dollar in damages. We pay every dollar of damages 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. Chances are you’ll never face an out-of-pocket expense.

no lengthy exclusIonsThat’s equally reassuring. In fact, we pride ourselves on offering the most

comprehensive coverage in the industry. Our job is to protect you in case of

claim, freeing you to do your job.

we pay deFense costsForged, incomplete or otherwise defective signatures can cast doubt on the

validity or date of a document. And when that happens, someone is to blame.

Too often, the blame is placed on you, the notary. Worse yet, even if the suit is

not valid you may not be spared the need to protect yourself from prosecution.

Without coverage you’ll have to pay these defense costs yourself.

Are you protected?

notary e & o beneFIts:

• No deductible

• Covers defense costs

• Every dollar of damages and legal costs paid up to policy limits

• Protects against errors and omissions

• Employers covered under blanket policy at no additional charge

• Additional notaries covered automatically under blanket policy

• Various limits of insurance available at nominal premiums

RLI Notary Errors & Omissions Insurance

RLI Surety

A division of RLI Insurance Company

P.O. Box 3967Peoria, IL 61612-3967

SD103-CBS (10/13)

conservatIve. dIscIplIned. successFul.

Disciplined underwriting and conservative investments have made RLI one of America’s premier property and casualty insurers.

• A.M. Best rating: A+, Superior

• Standard & Poor’s rating: A+ (Strong)

• Named to Ward’s 50 — a select group of top insurance companies based on financial safety, consistency and performance — every year since 1991

• 24-hour turn around time on all new business

APPLICATION Submit your application to CBS Agency, Inc.

c Individual Policy

Name _____________________________________________________________________

Address ___________________________________________________________________

City ___________________________________________ State _______ Zip ___________

Phone ______________________________ Email _________________________________

Date of Commission _________________________________________________________

Amount of Coverage$ ________________________________________________________

c Blanket Policy

Employer’s Name ___________________________________________________________

Address ___________________________________________________________________

City ___________________________________________ State _______ Zip ___________

Phone ______________________________ Email _________________________________

Number of Notaries _________________________________________________________

Amount of Coverage$ ________________________________________________________

Credit Card Payments

Credit Card Number _________________________________________________________

Name on Card __________________________________________ Exp. Date___________

c Check here if this application has been previously faxed.

Protection against errors and omissions is more important than ever because lawsuits against notaries are becoming more common each day. Your agent can get RLI’s affordable coverage for you. Call today.

YOuR LOcaL RLI agENt Is:

CBS AgeNCy, INC175 S. Third Street, Suite 1100Columbus, OH 43215

Ph: 614-340-2076 • Fax: 614-340-2080Email: bonds@cbalaw.org

Agency Code: 47310

INdIvIduAL NOTAry PuBLIC LImITS ANd Term PremIumS

$5,000.00 .......... $38.00/5-yr. premium

$10,000.00 .......... $63.00/5-yr. premium

$25,000.00 .......... $94.00/5-yr. premium

BLANkeT NOTAry PuBLIC LImITS ANd Term PremIumS

$5,000.00 ........ $8.00/per year per Notary

$10,000.00 ...... $13.00/per year per Notary

$25,000.00 ...... $19.00/per year per Notary