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Request for Notary Status Information


Please prepare the status information for following notary public:

** required

County: (where notary lives)
Docket/File #: (if applies)

The notary status information should be sent to:

First Name*:  MI:    Last Name*:


Street*: Suite/P.O.Box:
City*: County: (for NJ only)
State*: (required in US only) Zip Code: -
Additional Contact Information
Name (if different from above):
E-mail address*:
Telephone #: ( ) - ext


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Copyright State of New Jersey, 2008
Division of Revenue

Last Updated: February 8, 2008
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