Becoming A Notary Just Got Easier

P.O. Box 7457 Tallahassee, FL 32314-7457800.826.2297 info.ks@npuonline.comBecoming a Notary Just Got Easier.Dear Notary Applicant:Notary Public Underwriters of Kansas has made it easy for you or your staff to become a notary public. Follow the simple stepsbelow!STEP 1 APPLICATIONFill in all blanks. Print your full first and last name. To use initials in place of your first name (J. Marie Doe or J. M.Doe), you must submit a photo copy of a government-issued ID that shows an initial for your first name. Prefixes (Dr.,Mrs., etc.) are not acceptable. Print the physical street address of your residence and place of employment. Post officeboxes are not acceptable. Please enter your daytime and secondary phone numbers. Enter your expiration date if you arecurrently a Kansas notary public or if you have ever been a Kansas notary public. We will affix your notary stamp thatyou purchased with your package. If you have purchased an updated stamp from another source, please affix the stamp.OATH - Sign at field eight (8), Applicant’s signature, as your name appears in field one (1), Applicant’s name, in thepresence of a notary public.NOTARY SURETY BOND - Leave this section blank. We will complete your bond and deliver it to the Secretary of State forprocessing.STEP 2 ORDER FORMSelect a notary package which contains a notary stamp that is required by law. Indicate your stamp case color whereapplicable. Select additional supplies you wish to purchase and total your order.STEP 3 PAYMENTMail the completed forms with a credit card number, check or money order made payable to NOTARY PUBLICUNDERWRITERS OF KANSAS in the enclosed envelope. We will mail your customized stamp and other supplieswithin three business days after we receive notification of commission. All NOTARY PUBLIC UNDERWRITERS OFKANSAS stamps and seals come with a Lifetime Guarantee.Apply for your notary public commission today! We look forward to serving you.Sincerely,Jack Diestelhorst, Owner23NOTARY PUBLIC UNDERWRITERS OF KANSASCelebrating 23 Years in the Business!A Proud Partner of theAmerican Society of Notarieswww.NotaryPublicUnderwriters.com 800.826.2297KS-30 (09/20)

PD leaSt o N seap otleNOKANSAS SECRETARY OF STATENotary PublicAppointment FormMemorial Hall, 1st Floor120 S.W. 10th AvenueTopeka, KS 66612-1594(785) IS SPACE FOR OFFICE USE ONLY.your notary appointment, please do not submit this form before 90 days prior to your expiration date. YouPlease check one:oNew appointmentoReappointmentExpiration date of your most recent Kansas appointment:MonthDayYear(Your current expiration date must be used until the date of expiration has passed.)A. Personal Information1. Applicant’s name (Must match name on the seal in Item 7.)Previous name (If your name has changed from the previous appointment.)2. Residential street address (P.O. box is not acceptable.)3. Mailing address (Optional)Residential Street AddressStreet AddressCityStateZip4. Daytime phone (Required)5. Secondary phone (Optional)(Name on seal/stamp must match applicant’s name in Item 1.)CityStateZip6. This section must be completed. Are you at least 18 years of age?oYesoNo Are you a resident of Kansas or a resident ofa state bordering Kansas who regularly carrieson a business or profession in this state or isregularly employed in this state?oYesoNo Are you able to read and write the Englishlanguage?oYesoNo Have you ever been convicted of a felony orof a lesser offense involving moral turpitude orof a nature incompatible with the duties of anotary public? A conviction after a plea of nolocontendere is deemed to be a conviction.oYesoNo Have you ever had a revocation, suspension ordenial of a professional license for misconduct,dishonesty or any cause substantially relating tothe duties or responsibilities of a notary public?oYesoNoP-5141/2K.S.A. 53-103Rev. 9/17/19 tcContinue to next page

B. Oath8. Applicant’s signature9. State ofCounty of(Seal)MonthDayYear11. My appointment expires:MonthDay12. Notary’s signatureYear* You may say the phrase inside the parentheses instead of the italicized words.C. Notary Surety Bond (The surety company must complete this section)Know All Persons By These Presents: That we, the above-named applicant as principal and13. Name and address of surety companyUNIVERSAL SURETY OF AMERICAStreet Address101 S. Reid St, Ste 300CityStateSioux FallsSDZip57103-7045as surety company, give bond payable to any individual who may be harmed as a result of a breach of duty by said applicant acting in his/for the term of four years in accordance with the laws of this state. Now, therefore, if said applicant shall faithfully discharge the duties of14. Signature of Attorney-in-Fact(Corporate Seal)**DateMonthDayYear** Attach corporate seal or submit with the Power of Attorney.2/2K.S.A. 53-103Rev. 9/17/19 tcPlease review to ensure completion.

ORDER FORM1.800.826.2297 www.NotaryPublicUnderwriters.com ORDER ONE OF THESECOMPLETE NOTARY PACKAGES!Premium Notary Package 4 Year 7,500 Notary Bond - 50.00(With free 10,000 Errors & Omissions Policy) P.O. Box 7457 Tallahassee, FL 32314-7457800.826.2297 info.ks@npuonline.com State Filing Fee - 25.00Rectangular Self-Inking Stamp - 24.009900 (your choice of stamp case color!)Classic Notary Package 4 Year 7,500 Notary Bond - 50.0010200 (With free 10,000 Errors & Omissions Policy) State Filing Fee - 25.00Round Self-Inking Stamp - 27.00(your choice of stamp case color!)P-514Deluxe Notary Package 4 Year 7,500 Notary Bond - 50.00 18900 (With free 10,000 Errors & Omissions Policy) State Filing Fee - 25.00Rectangular Self-Inking Stamp - 24.00(your choice of stamp case color!) PRODUCT DESCRIPTIONQTYPremium Notary Package (choose stamp case color)Classic Notary Package (choose stamp case color)Deluxe Notary Package (choose stamp case color)Notary Bond & State Filing FeesPRICECOST 99.00 102.00 189.00 75.00( ) Choose your stamp case 50.00 80.00 208.00 416.00ADDITIONAL SUPPLIESRound Self-Inking Stamp (choose stamp case color)Notary Public Record BookHeavy Duty Round Self-Inking StampNotary Self-Inking Stamp (choose stamp case color)COLOR:Rectangular Self-Inking Stamp4 YEAR ERRORS & OMISSIONS POLICIES 10,000 Errors & Omissions Policy 25,000 Errors & Omissions Policy 50,000 Errors & Omissions Policy 100,000 Errors & Omissions PolicyRecord Book - 10.00 25,000 Errors & Omissions Policy - 80.00 27.00 10.00 38.00 RedMintBlack (Default)Round Self-Inking StampSee Reverse Sidefor ProductDescriptions!Expiration Date Self-Inking Stamp (choose stamp case color)RedGreyWhiteGreenBlueFuchsiaBlack (Default)Purple 19.00Blue & PinkBlack (Default) 25.50BlueRedBlack (Default)Mobile Stamp (choose stamp case color)FuchsiaSilverBlueWhiteRedGreen & BlueNotary Embosser (additional colors available online)Impression Inker (For use with the Notary Embosser)Notary Study CourseAmerican Society of Notaries One Year MembershipShipping & HandlingIf we cannot process your order within 12 months due to lack ofinformation, we are no longer obligated to fulfill your order andpayment becomes non-refundable.Payment:CheckKS-07 (09/20)HomeBusinessOther Address:Business Name (If applicable)Street Address/PO Box 7.00AMOUNTENCLOSEDCityStateZipEmail Address (By providing your email address on the order form or application, you are opting in to receiveemails such as order statuses, renewal reminders, law updates and other notary related information.)Money OrderName On Card:Billing Zip Code:Mail my products to: 28.50 17.00 36.00 39.00Card No.:Phone:(XXX) XXX-XXXXExpires:Signature:For Credit Card Authorization OnlyMail Appointment Form, Order Form and Payment to: Notary Public Underwriters of Kansas, Inc. P.O. Box 7457 Tallahassee, FL 32314-7457MM/YY

ORDER YOUR NOTARY PUBLIC SUPPLIES NOW!RoundSelf-Inking StampBlueRedFor More Notary Products & Options Visit Our Website at www.NotaryPublicUnderwriters.comThe Trodat round self-inking stamp producesthousands of consistent impressions without theneed of a separate stamp pad. Designed to producean imprint equal in size to the notary embosser. Thisstamp can also be carried easily without the worry ofcreating a mess thanks to the cap suppliedin a color matching the stamp itself.YBlack (Default)Round State Approved NotaryStamp - not actual size.Notary PublicRecord Book2700 MR NA E HEROU TARY ENO1000 Record the details of the notarial acts youperform with this record book. It includesroom for 256 entries and complete “howto” instructions.Maintaining a record book is not requiredby Kansas law, but it is recommended by theSecretary of State.(Choose stamp case color on front of form.)MY APPOINTMENTEXPIRES 12-31-2024Self-Inking StampST P U B L I CSATE OF KANSAHeavy Duty 00RoundSelf-Inking Stamp38High-quality stamp designed for highvolume usage and many years ofservice. Great for notary andprofessional legal seals.Express yourself with one of our colorful self-inking stamps! ThePrinty stamp from Trodat is now available in many excitingcolors. Get clear, crisp impressions without using a stamp pad.(Choose stamp case color on front of form.)Notary StampATE OFST NOTARY PUBLICKAMobile Stamp2550 This compact stamp isperfect if you are always onthe go. It’s convenient fortraveling, while still producingcrisp, clear impressions, makingit a great addition to yourregular notary stamp.2400 State Approved Rectangular NotaryStamp - not actual size.If no stamp color is specified, you willreceive Black.NSASExpiration DateStamp1900 Must be used in conjunction with NotaryEmbosser - not actual size.YOUR NAME HEREMy Appointment ExpiresSeptember 30, 2024My Commission Expires:September 30, 2024NotaryEmbosser2850 This portable embosser,with soft rubber griphandle, produces a clear,raised impression withevery use. The superiorworkmanship and steelconstruction ensures the embosser will last forthe life of your commission and beyond.ImpressionInker1700 A must have, sinceKansas requires inking ofembossed seal imprints.The inker quicklymarks the raisedportion of theimpression withblack ink.Additional colors available online.Notary Study Course3600 Strengthen your notarial knowledge!The American NOTARY Study Course providesstandard notarial procedures and best practices.This comprehensive notary study course trainsprospective and current Kansas notaries toofficiate lawfully and confidently.American Society ofNotaries One Year Membership3900 The original association for notaries public in theUnited States. Benefits include a toll-free help line, freelisting in ASN’s All-States Notary Locator, law updatesand notarial guidelines, membership card, certificateand more.Lifetime Guarantee on all Stamps and Seals!1.800.826.2297 www.NotaryPublicUnderwriters.com