2018 Notary Public New Applicant Package
THE UNITED STATES VIRGIN ISLANDS OFFICE OF THE LIEUTENANT GOVERNOR 5049 Kongens Gade Charlotte Amalie, Virgin Islands 00802 Phone - 340.774.2991 Fax - 340.774.6953 1105 King Street Christiansted, Virgin Islands 00820 Phone - 340.773.6449 Fax - 340.773.0330 NOTARY PUBLIC COMMISSION FORM Rev. 03/2018 THE PROCESS FOR ADMISSION AS A NOTARY PUBLIC FOR THE UNITED STATES VIRGIN ISLANDS IS DONE IN THREE (3) PHASES: PHASE I - ELIGIBILITY THIS NOTARY PUBLIC COMMISSION FORM IS TO BE TURNED WITH THE FOLLOWING DOCUMENT ATTACHED: AFFIDAVIT – Fully completed, signed and notarized. CRIMINAL RECORD REPORT – This report should cover all three U.S. Virgin Islands. CHARACTER REFERENCE LETTERS – Two letters of character reference complete with the email and return addresses and daytime contact number of the authors. PROOF OF CITIZENSHIP w/PHOTO – Passport, Voters Identification or Birth Certificate and Photo CERTIFICATE OF GOOD STANDING FROM THE SUPERIOR COURT OF THE VIRGIN ISLANDS – Must be submitted for Attorneys Only. …
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THE UNITED STATES VIRGIN ISLANDS OFFICE OF THE LIEUTENANT GOVERNOR 5049 Kongens Gade Charlotte Amalie, Virgin Islands 00802 Phone - 340.774.2991 Fax - 340.774.6953 1105 King Street Christiansted, Virgin Islands 00820 Phone - 340.773.6449 Fax - 340.773.0330 NOTARY PUBLIC COMMISSION FORM Rev. 03/2018 THE PROCESS FOR ADMISSION AS A NOTARY PUBLIC FOR THE UNITED STATES VIRGIN ISLANDS IS DONE IN THREE (3) PHASES: PHASE I - ELIGIBILITY THIS NOTARY PUBLIC COMMISSION FORM IS TO BE TURNED WITH THE FOLLOWING DOCUMENT ATTACHED: AFFIDAVIT – Fully completed, signed and notarized. CRIMINAL RECORD REPORT – This report should cover all three U.S. Virgin Islands. CHARACTER REFERENCE LETTERS – Two letters of character reference complete with the email and return addresses and daytime contact number of the authors. PROOF OF CITIZENSHIP w/PHOTO – Passport, Voters Identification or Birth Certificate and Photo CERTIFICATE OF GOOD STANDING FROM THE SUPERIOR COURT OF THE VIRGIN ISLANDS – Must be submitted for Attorneys Only. PHASE 2 – APPROVAL OF BOND After your application has been reviewed and you have been deemed eligible for an appointment as a Notary Public, you MUST submit the Commission Fee of $100.00, payable to the Government of the Virgin Islands. A Notary Bond, with a face value of $5,000.00, must also be submitted from an insurance or bonding company authorized to do business in the Virgin Islands OR you may choose to submit a Surety Bond from two (2) resident sureties, who are owners of real property within the Virgin Islands, with a value of $10,000.00 over and above encumbrances thereon. All owners of each property must sign both the Bond and Justification of Surety. The Bond and Affidavit will go to the Supreme Court for approval by the Presiding Judge. I HAVE SUBMITTED THE FOLLOWING: COMMISSION FEE of $100.00 payable to the Government of the Virgin Islands. ONLY checks and money orders will be accepted at the Kongens Gade (Government Hill) location on St. Thomas NOTARY BOND (check one) Insurance Bond in my application name, signed and witnessed, with Power of Attorney attached; OR Surety Bond with two (2) Justifications of Surety. The location and value of the property is stated in the surety documents before the sureties’ signatures. CERTIFICATION – Completed by a Notary Public notarizing my signature on the Bond (Insurance Bonds ONLY) NOTARY PUBLIC COMMISSION APPLICATION INSTRUCTIONS FOR NEW APPLICANTS NOTARY PUBLIC COMMISSION FORM Rev. 03/2018 PHASE 3 – ISSUANCE OF COMMISSION When the Bond is returned “APPROVED” by the Supreme Court, a Notary Public Commission will be issued, in your application name, with the effective and expiration dates, and your Notary Public number (NP-NNN-YY). The law governing Notary Public in the U.S. Virgin Islands will be included in your packet. You are responsible for reading the law and making yourself familiar with its provisions and your duties as a Notary Public, and obtaining the proper Notary Seal. I HAVE SUBMITTED THE FOLLOWING DOCUMENTS TO COMPLETE MY NOTARY PUBLIC COMMISSION FORM – NOTARY’S OATH – Signed and notarized. IMPRINT OF NOTARY SEAL - Information captured on seal must include – Name as it appears on Notary Commission documents The words “NOTARY PUBLIC” Commission Expires (MM/DD/YYYY) Judicial District – (STT/STJ, USVI) or (STX, USVI) SPECIAL NOTE: THE SIGNATURES ON THE APPLICATION, AFFIDAVIT, CERTIFICATION AND BOND AND OATH SHOULD BE THE SAME. THE UNITED STATES VIRGIN ISLANDS OFFICE OF THE LIEUTENANT GOVERNOR 5049 Kongens Gade Charlotte Amalie, Virgin Islands 00802 Phone - 340.774.2991 Fax - 340.774.6953 1105 King Street Christiansted, Virgin Islands 00820 Phone - 340.773.6449 Fax - 340.773.0330 NOTARY PUBLIC COMMISSION FORM Rev. 03/2018 PLEASE COMPLETE THIS APPLICATION IN ITS ENTIRETY. LEAVE NO BLANKS. DATE NAME LEGAL LAST NAME LEGAL FIRST NAME MIDDLE INITIAL MAILING ADDRESS POB OR STREET ADDRESS (IF YOU RECEIVE MAIL AT A PHYSICAL ADDRESS), CITY, STATE, ZIP RESIDENTIAL ADDRESS STREET ADDRESS, CITY, STATE, ZIP HOW LONG AT THIS RESIDENTIAL ADDRESS CONTACT NUMBERS HOME CELLULAR EMAIL ADDRESS EMPLOYER OCCUPATION ADDRESS TELEPHONE NUMBER NOTARY PUBLIC COMMISSION APPLICATION NEW APPLICANT NOTARY PUBLIC COMMISSION FORM Rev. 03/2018 PLEASE MARK AND X IN THE APPROPRIATE BOX WHEN RESPONDING TO THE FOLLOWING QUESTIONS – YES NO Are you 21 years of age or older? Are you a resident of the United States Virgin Islands? If yes, how long? Did you graduate from high school OR have you completed the GED Program? Please provide name of high school - Please provide city and state - Have you ever been convicted of or pled guilty to any crime in the United States Virgin Islands, any other U.S. jurisdiction or any other country? Please attach criminal report. If you are an Attorney, have you attached a Good Standing Certificate from the Supreme Court? Please check this box □ if not applicable. Have you ever been issued commission as a Notary Public in the Virgin Islands? If yes, please indicate the date your commission expired or will expire - . Please provide name under which you were previously commissioned, if different from name listed on this application - . Have you ever been refused a commission, had a commission revoked or been subjected to an administrative penalty as a Notary Public? If yes, attach a separate letter indicating the Country, State, reason and date. SIGNATURE OF APPLICANT NOTARY PUBLIC COMMISSION FORM Rev. 03/2018 AFFIDAVIT TERRITORY OF THE VIRGIN ISLANDS ) ) DISTRICT OF ST. ) I, , residing at , being duly sworn, depose and state: 1. I am a citizen of the United States and a resident of the Virgin Islands. 2. I have resided in the Virgin Islands for the past years. 3. I am over 21 years of age. 4. I am a graduate of an accredited High School; OR I have passed the High School Equivalency Test (GED). 5. I have never been convicted of any crime either within or outside of the Virgin Islands. 6. I will continue to reside in the Virgin Islands during the term of my commission. This Affidavit is made for the purpose of having issued to me a Notary Public Commission for the Virgin Islands. Signature Subscribed and sworn to before me this day of , 20 . SEAL Notary Public My Commission Expires: Notary Number: NOTARY PUBLIC COMMISSION FORM Rev. 03/2018 GOVERNMENT OF THE VIRGIN ISLANDS OFFICE OF THE LIEUTENANT GOVERNOR CONSENT FOR CRIMINAL BACKGROUND HISTORY CHECK Pursuant to 3 V.I.C. Section 772(4), to qualify as a Notary Public in the United States Virgin Islands, a person shall not have been convicted of any crime either within or outside of the Territory. The following information is needed to conduct a NCIC background check of all persons seeking to be appointed or reappointed to be a Notary Public. I HEREBY GIVE MY PERMISSION FOR THE GOVERNMENT OF THE VIRIGN ISLANDS, OFFICE OF THE LIEUTENANT GOVERNO, TO OBTAIN INFORMATION RELATING TO MY CRIMINAL HISTORY. THE CRIMINAL HISTORY RECORD, AS RECEIVED FROM THE REPORTING AGENCIES, MAY INCLUDE ARREST AND CONVICTION DATA. I UNDERSTAND THAT THIS INFORMATION WILL BE USED, IN PART, TO DETERMINE MY ELIGIBILITY TO BE A NOTARY PUBLUIC IN THE UNITED STATES VIRGIN ISLANDS. I ALSO UNDERSTAND THAT AS LONG AS I REMAIN A NOTARY PUBLIC, THE CRIMINAL HISTORY RECORDS CHECK MAY BE REPEATED AT ANY TIME FOR CAUSE RELATED TO MY APPOINTMENT. I, THE UNDERSIGNED, DO, FOR MYSELF, MY HEIRS, EXECUTOR AND ADMINISTRATORS, HEREBY REMISE, RELEASE AND FOREVER DISCHARGE AND AGREE TO INDEMNIFY AND HOLD THE GOVERNMENT OF THE VIRGIN ISLANDS, OFFICE OF THE LIEUTENANT GOVERNOR AND EMPLOYEES AND AGENTS HARMLESS FROM AND AGAINST ANY AND ALL CAUSES OF ACTIONS, SUITS, LIABILITIES, COST, DEBTS AND SUM OF MONEY, CLAIMS AND DEMANDS WHATSOEVER, AND ANY AND ALL RELATED ATTORNEY FEES, COURT COSTS, AND OTHER EXPENSES RESULTING FROM THE INVESTIGATION OF MY BACKGROUND IN CONNECTION WITH MY APPLICATION TO BECOME A NOTARY PUBLIC. APPLICANT SIGNATURE DATE PLEASE PRINT THE INFORMATION LEGIBLY: 1. BIRTH NAME LAST FIRST M.I. MAIDEN NAME (OR ANY OTHER NAMES USED): _____________________________ 2. PHYSICAL ADDRESS:_________________________________________________ 3. DATE OF BIRTH:______________________________________________________ 4. SOCAIL SECURITY NUMBER: __________________________________________ 5. DRIVERS LICENSE NUMBER: __________________________________________