South Dakota Administrative Rules › Title 5 - Secretary of State › Article 5:04 - Office of the Secretary of State › Chapter 5:04:03 - Notaries public › Section 5:04:03:01 - Notary public application, oath, and bond form

Current through Register Vol. 51, page 10, July 15, 2024
The application and bond form for a notary public is as follows:
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(1) Front side:
State of South Dakota
Notary Public
Application, Oath & Bond
Filing Fee: $30.00 (Must be included to file)
MAKE IMPRINT OF SEAL HERE Submit to: Secretary of State, 500 East Capitol Ave., Pierre, SD 57501-5077
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(Imprint required for processing)
Type or print
neatly - please read instructions and complete all sections.
TO THE SECRETARY OF STATE OF SOUTH DAKOTA: I hereby respectfully apply to be commissioned as a Notary Public for the State of South Dakota.
NAME ________________________________________________________________
(print your name
EXACTLY
as found on your seal imprint)
RESIDENCE ADDRESS
(Not business address) ___________________________________________________
CITY _____________________________ STATE ___________ ZIP_______________
MAILING ADDRESS____________________________________________________
CITY _____________________________ STATE ___________ ZIP_______________
COUNTY ________________________________
PHONE _____________________ EMAIL (Optional) _________________________
Have you ever been a SD Notary Public? _____Yes _____No If yes, when did/does your commission expire? _______________
What name was your commission under: _______________________________________________________
Date of Birth _________________ Have you ever been convicted of a felony?__________________________
Complete the following if you reside in an out-of-state county bordering South Dakota:
Employer/Business Name: ___________________________________________________________________________________
South Dakota Business Address: ___________________________________________________________________________________
Street City State Zip
STATE OF SOUTH DAKOTA
OATH (MUST be completed and signed)
COUNTY OF ____________________
I, _______________________________________________, being first duly sworn, depose and state that the (print your name
EXACTLY
as found on your seal imprint)
answers to the questions on this application are true and complete to the best of my knowledge and that I am of legal age and meet the state residency requirements of SDCL  18-1-1. I do solemnly swear that I will support the Constitution of the United States and the Constitution of the State of South Dakota and that I will faithfully and impartially perform the duties of a NOTARY PUBLIC within and for the State of South Dakota according to the law and to the best of my ability, so help me God.
Dated_______________________ ___________________________________________________________
(Applicant's Signature - sign name EXACTLY as found on your seal imprint)
(Entire section must be completed for a Bond) BOND Bond No. ____________
(If a Personal Surety is being used, omit the following and complete the Personal Surety form on the backside.)
We,____________________________________, as principal, and __________________________________are
(name of notary applicant) (name of surety company)
(print your name
EXACTLY
as found on your seal imprint)
bound to the State of South Dakota in the penal sum of $5000.00 for payment of which we bind ourselves, our successors, or representatives, executors, and administrators jointly and severally hereby. This obligation is conditioned upon appointment and commission as a Notary Public of the above-named Principal by the Secretary of State and covers the official term of six (6) years from the date of appointment. If the Principal performs well and faithfully all of the duties of the office of Notary Public according to the laws of South Dakota, then the above obligation is to be null and void, otherwise, it is to remain in effect.
Dated this ___________ day of _______________ _______________________________________________
(Applicant's Signature)
(sign your name
EXACTLY
as found on your seal imprint)
______________________________________________________________________
(Both Signatures Required)
(Surety's Signature)
Approved by the South Dakota Attorney General
File Date: _______________________
Commission date: ________________________
Receipt number: ________________________
Notary ID: ________________________
(2) Reverse side:
Personal Surety Form
Know all by these presents: That we, __________________ (Notary applicant's name
EXACTLY
as found on your seal imprint), of the County of _________________ and the State of South Dakota, as principal, and __________________________(Personal Surety's name), County of ___________________, ________________________________________(Address), State of South Dakota, as surety, are individually held firmly bound unto the State of South Dakota in the penal sum of five thousand dollars, for the payment of which we hereby jointly and severally bind ourselves, our heirs, executors, administrators and successors. Further, each of us deposes and says individually that we are worth $5000, the amount of the bond, over and above our debts and liabilities, in unencumbered property, exclusive of property exempt from execution and forced sale under the laws of this state.
The conditions of this obligation are such that, if the above principal, _________________ (Notary applicant's name EXACTLY as it appears on your seal imprint), who has or will be appointed Notary Public in the State of South Dakota, shall faithfully execute the duties of the office according to law, then this obligation shall be null and void, otherwise to remain in full force and effect.
Dated this ______day of ______________ __________________________________________________
Applicant's Signature - EXACTLY as found on your seal imprint)
Subscribed and sworn to before me this __________ day of _______________________.
__________________________________
(SEAL) Notary Public
My commission expires: ______________
Dated this ________day of _______________________. _____________________________________
Personal Surety's Signature
Subscribed and sworn to before me this __________ day of _______________________.
__________________________________
(SEAL) Notary Public
My commission expires: ______________
PLEASE NOTE
A personal surety is liable for the bond for the six-year commission of the notary.
A personal surety
cannot
have the personal surety's name removed from the bond for any reason.
A personal surety or the applicant
cannot
notarize the Personal Surety Form.
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General Authority:
SDCL  18-1-1.
Law Implemented:
SDCL  18-1-1,  18-1-3.