Form Ds/de 76 - Notary Public Commission Application Form With Memorandum (Page 2 of 3) in pdf

OATH OF OFFICE

STATE OF FLORIDA

________________________ COUNTY

I do solemnly swear (or affirm) that I will support, protect, and defend the Constitution and Government of the United States and of the State of Florida;

that I am duly qualified to hold office under the Constitution of the state; that I have read Chapter 117, Florida Statutes, and any amendments thereto, and

know the duties, responsibilities, limitations, and powers of a notary public; and that I will well and faithfully perform the duties of Notary Public, State of

Florida, on which I am now about to enter. So help me God.*

UNDER PENALTY OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING APPLICATION AND OATH, AND THAT THE FACTS

STATED THEREIN ARE TRUE. I accept the Office of Notary Public, State of Florida.

(Official Signature of Applicant)

(Date)

*Note:

If you affirm, you may omit the words

“So help me God.” Fla. Stat. §92.52

(Print or Type Name – Name for which your commission will be issued)

MEMORANDUM

AS A GENERAL MATTER, APPLICATIONS FOR ALL POSITIONS WITHIN STATE GOVERNMENT ARE PUBLIC RECORDS, WHICH MAY

BE VIEWED BY ANYONE UPON REQUEST. HOWEVER, THERE ARE SOME EXEMPTIONS FROM THE PUBLIC RECORDS LAW FOR

IDENTIFYING INFORMATION RELATING TO SOCIAL SECURITY NUMBERS, PAST AND PRESENT LAW ENFORCEMENT OFFICERS

AND THEIR FAMILIES, VICTIMS OF CERTAIN CRIMES, ETC. IF YOU BELIEVE AN EXEMPTION FROM THE PUBLIC RECORDS LAW

APPLIES TO YOUR FLORIDA NOTARY PUBLIC COMMISSION APPLICATION SUBMISSION, PLEASE CHECK THE FOLLOWING BOX:



Yes, I assert that identifying information provided in this application (other than my social security number, which I am aware is automatically

exempt from public disclosure, pursuant to Fla. Stat. §119.071(5)(a)5) should be excluded from inspection under Public Records Law.

If Yes, please indicate what section of Florida Statutes provides this exemption in your particular situation:

IF YOU NEED ADDITIONAL GUIDANCE AS TO THE APPLICABILITY OF ANY PUBLIC RECORDS LAW EXEMPTION TO YOUR

SITUATION, PLEASE CONTACT THE OFFICE OF THE ATTORNEY GENERAL:

Office of the Attorney General

The Capitol, PL-01

Tallahassee, FL 32399

(850) 245-0158

###

Form Ds/de 76 - Notary Public Commission Application Form With Memorandum Page 2

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