NOTARY PUBLIC COMMISSION RENEWAL FORM Rev. 01/2021 GOVERNMENT OF THE VIRGIN ISLANDS OF THE UNITED STATES OFFICE OF THE LIEUTENANT GOVERNOR NOTARY PUBLIC COMMISSION RENEWAL INSTRUCTIONS THE PROCESS FOR RENEWING A NOTARY PUBLIC COMMISSION FOR THE UNITED STATES VIRGIN ISLANDS IS DONE IN TWO (2) PHASES PHASE 1 SUBMITTAL OF DOCUMENTS AND APPROVAL OF BOND You MUST submit the Commission renewal fee of $75.00, plus any outstanding annual fees, payable to THE GOVERNMENT OF THE VIRGIN ISLANDS. A Notary Bond must also be submitted with a face value of $5,000.00, from an insurance or bonding company authorized to do business in the United States Virgin Islands OR you may choose to submit a Surety Bond from two (2) resident sureties who are owners, within the Virgin Islands, of real property 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. COMMISSION RENEWAL FEE - $75 payable to the Government of the Virgin Islands. ONLY checks and money orders will be accepted at the 5049 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. (bonds from insurance companies only) AFFIDAVIT – Fully completed, signed and notarized. CRIMINAL RECORD REPORT – Covering all three (3) U.S. Virgin Islands. CHARACTER REFERENCE LETTERS – Two letters of character reference complete with the return address and daytime contact number of the authors. PROOF OF CITIZENSHIP w/PHOTO – Passport, Voters Identification, Birth Certificate and Photo Identification. CERTIFICATE OF GOOD STANDING FROM THE SUPERIOR COURT OF THE VIRGIN ISLANDS – For Attorneys Only. NOTARY PUBLIC COMMISSION RENEWAL FORM Rev. 01/2021 PHASE 2 ISSUANCE OF COMMISSION When the Bond is returned “APPROVED” by the Superior 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) The Signatures on the APPLICATION, AFFIDAVIT, BOND and OATH Should be the same. Quick Facts _________A notary must notify this office of any changes to the information provided on this application in writing. _________A notary must always keep a registry book/ journal no matter how many or few notaries they perform. _________The maximum fee by law a notary can charge is $5.00 per notarial act. _________A notary is not authorized to perform marriages, certify birth, marriage/death certificates or any act that constitutes the practice of law. A notary is not an attorney and cannot practice as one. ___________A notary must always be completely satisfied with the identity of the person whose signature is being notarized. A notary is not obligated to notarize a person’s signature without being sure that the person is who he or she claims to be. Always check identification and be satisfied that the ID is valid. NOTARY PUBLIC COMMISSION RENEWAL FORM Rev. 01/2021 GOVERNMENT OF THE VIRGIN ISLANDS OF THE UNITED STATES OFFICE OF THE LIEUTENANT GOVERNOR 5049 Kongens Gade Charlotte Amalie, Virgin Islands 00802 1(340) 774-2991 NOTARY PUBLIC COMMISSION RENEWAL APPLICATION 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 (IF YOU RECEIVE MAIL AT A PHYSICAL ADDRESS), CITY, STATE, ZIP RESIDENTIAL ADDRESS STREET ADDRESS, CITY, STATE, ZIP HOW LONG AT THIS RESIDENTIAL ADDRESS EMAIL ADDRESS _____________________________________________ CONTACT NUMBERS HOME CELLULAR EMPLOYER OCCUPATION ADDRESS TELEPHONE NUMBER NOTARY PUBLIC COMMISSION RENEWAL FORM Rev. 01/2021 PLEASE MARK AND X IN THE APPROPRIATE BOX WHEN RESPONDING TO THE FOLLOWING QUESTIONS YES NO 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 Superior Court? Please check this box □ if not applicable. 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 SIGN NOTARY PUBLIC COMMISSION RENEWAL FORM Rev. 01/2021 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 ______ 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 Public Number ________________ SIGN SIGN NOTARY PUBLIC COMMISSION RENEWAL FORM Rev. 01/2021 CERTIFICATION INSTRUCTIONS: This Certificate is to be completed by another Notary Public in support of your Notary Bond Application. TERRITORY OF THE VIRGIN ISLANDS ) JUDICIAL DIVISION OF ) ___________________________ ) I, ___________________________________, a Notary Public in and for the Territory of the Virgin Islands District of ___________________________________, do hereby certify that ________________________________________, as Principal, is personally known to me to be the same person whose name subscribed to the foregoing Notary Bond, appeared before me this day in person, and acknowledged that he-she signed, sealed and delivered said instrument as his/her free and voluntary act, for the uses and purposes therein set forth. GIVEN UNDER MY HAND AND SEAL, THIS ___ DAY OF ______________, 20____, A.D. ___________________________ NOTARYPUBLIC MY COMMISSION EXPIRES: ______________ NOTARY PUBLIC NO. ___________________ SIGN NOTARY PUBLIC COMMISSION RENEWAL FORM Rev. 01/2021 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) National Crime Information Center 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 GOVERNOR, 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 PUBLIC 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. SOCIAL SECURITY NUMBER: _______________________________________ 5. DRIVERS LICENSE NUMBER: _______________________________________ SIGN NOTARY PUBLIC COMMISSION RENEWAL FORM Rev. 01/2021 JUSTIFICATION OF SURETY IN THE SUPERIOR COURT OF THE VIRGIN ISLANDS DIVISION OF ST. ___________________ IN THE MATTER OF THE BOND OF , NOTARY PUBLIC. TERRITORY OF THE VIRGIN ISLANDS ) JUDICIAL DIVISION OF ) SS: , BEING DULY SWORN ACCORDING TO LAW, DEPOSE AND SAY: I. THAT I AM THE PERSON NAMED IN AND WHO SUBSCRIBED THE NOTARY BOND GIVEN BY FOR NOTARY COMMISSION. II. THAT I AM A RESIDENT OF ST. , VIRGIN ISLANDS. III. THAT I HAVE PROPERTY LIABLE TO EXECUTION IN THIS JURISDICTION, WORTH $10,000 AND UPWARDS, EXCLUSIVE OF PROERTY EXEMPT FROM EXECUTION AND AFTER PAYING ALL DEBTS. Real Estate Owned: _______________________________________$ ____________________ __________________________________ ____________________________ CO- Surety (IES) SURETY Subscribed and sworn to before me this _____ day of ____________________, 20___. ___________________________ Notary Public My Commission Expires: ______________ Notary Public Number ________________ SIGN SIGN SIGN NOTARY PUBLIC COMMISSION RENEWAL FORM Rev. 01/2021 JUSTIFICATION OF SURETY IN THE SUPERIOR COURT OF THE VIRGIN ISLANDS DIVISION OF ST. ___________________ IN THE MATTER OF THE BOND OF , NOTARY PUBLIC. TERRITORY OF THE VIRGIN ISLANDS ) JUDICIAL DIVISION OF ) SS: , BEING DULY SWORN ACCORDING TO LAW, DEPOSE AND SAY: I. THAT I AM THE PERSON NAMED IN AND WHO SUBSCRIBED THE NOTARY BOND GIVEN BY FOR NOTARY COMMISSION. II. THAT I AM A RESIDENT OF ST. , VIRGIN ISLANDS. III. THAT I HAVE PROPERTY LIABLE TO EXECUTION IN THIS JURISDICTION, WORTH $10,000 AND UPWARDS, EXCLUSIVE OF PROERTY EXEMPT FROM EXECUTION AND AFTER PAYING ALL DEBTS. Real Estate Owned: _______________________________________$ ____________________ __________________________________ ____________________________ CO- SURETY (IES) SURETY Subscribed and sworn to before me this _____ day of ____________________, 20___. ___________________________ Notary Public My Commission Expires: ______________ Notary Public Number ________________ SIGN SIGN SIGN Rev. 1/2021 NOTARY BOND KNOW ALL MEN BY THESE PRESENT, that I,___________________ of St. ______________________, Virgin Islands of the United States, as Principal; and (SURETY NO. 1)_________________________________ (CO-SURETY NO. 1)_________________________________ (SURETY NO. 2)________________________________ (CO-SURETY NO. 2)_________________________________ All of St. ________ , Virgin Islands of the United States, as Sureties, are held and firmly bound onto the Government of the Virgin Islands of the United States, in the sum TEN THOUSAND DOLLAR ($10,000.00), in accordance with 3 V.I. Code Sec. 773 (b), for the payment whereof well and truly to be made, we bind ourselves, our heirs, executors and administrator, jointly and severally, firmly by these presents. WITNESS OUR NAMES AND SEAL THIS________DAY OF ___________________________, 20 ______. THE CONDITION OF THE ABOVE OBLIGATION is such that whereas the said _ has applied to the Lieutenant Governor of the Virgin Islands for a commission as a notary public in and or the Territory of the Virgin Islands, (District of St. _ ), if the said __ shall well and faithfully perform duties of said notary public according to law, and shall in general do and perform all other acts which may at any time be required of him/her by law, then this obligation to be void; otherwise to remain in full force and effect pursuant to 3 V.I. Code Chapter 29. WITNESSES ___________________________________________ __________________________________ PRINCIPAL ___________________________________________ __________________________________ (SURETY No. 1) ___________________________________________ __________________________________ (CO-SURETY No. 1) ___________________________________________ __________________________________ (SURETY No. 2) ___________________________________________ __________________________________ (CO-SURETY No. 2) TERRITORY OF THE VIRGIN ISLANDS ) JUDICIAL DISTRICT OF _____________________) SS: I, ___________________________, A notary public in and for the Territory of the Virgin Islands, District of _________________, DO HEREBY CERTIFY that ________________________________as Principal, and (SURETY NO. 1)_________________________________ (CO-SURETY NO. 1)__________________________________ (SURETY NO. 2)________________________________ (CO-SURETY NO. 2)__________________________________ As Sureties, who are each personally known to me to be the same persons whose names are subscribed to the foregoing instrument, appeared before me this day in persona, and acknowledged that they signed, sealed and delivered said instrument as their free and voluntary act, for the uses and purposes therein set forth. GIVE UNDER MY HAND AND SEAL THIS ______________DAY OF _____________________, 20___________A.D. Approved this ______day of ___________________, 20____________. _______________________________ Notary Public _____________________________ My Commission Expires____________________ PRESIDING JUDGE Superior Court of the Virgin Islands Notary Public No. ________________________ SIGN SIGN SIGN SIGN SIGN SIGN SIGN SIGN SIGN SIGN SIGN SIGN