Commission Number # * Please provide us with your Previous full name. First * Middle name or initial (If no middle name type NMN). Middle * Last * Please provide us with your New full name, as it appears on your current Oregon notary commission. First Middle Last Do you want to add your business name to your page? (Must be on file with the Oregon Secretary of State Corporation Division.) Business Do you want an address to be posted on the site in the Contact Information area? Select option No: Call for an appointment Yes: Mailing Yes: Physical What is your new address? New Address City State Select a State California Idaho Nevada Oregon Washington Zipcode What is your area code and phone number? Phone What is your preferred contact time? (Example: Monday - Friday 8:00am - 5:00pm) Hours What is your email address? (Example: name@domain.com) Email * What county are you located in? County Please Choose a County Baker Benton Clackamas Clatsop Columbia Coos Crook Curry Deschutes Douglas Gilliam Grant Harney Hood River Jackson Jefferson Josephine Klamath Lake Lane Lincoln Linn Malheur Marion Morrow Multnomah Polk Sherman Tillamook Umatilla Union Wallowa Wasco Washington Wheeler Yamhill What cities will you serve? If you only notarize in certain cities within the county please let us know. If you are willing to travel to any city write "All". Cities What languages do you read, write, and understand that you are able to perform a notarization in? If you only perform notarizations in English, please write "English". Languages When does your current notary commission expire? example: (January 20, 2015) Date Do you have an embosser? Embosser Yes No Security Code *