NOTARY PUBLIC COMMISSION RENEWAL FORM Rev. 01/2019 THE UNITED STATES VIRGIN ISLANDS OFFICE OF THE LIEUTENANT GOVERNOR 1105 King Street Christiansted, Virgin Islands 00820 Phone - 340.773.6449 Fax - 340.773.0330 5049 Kongens Gade Charlotte Amalie, Virgin Islands 00802 Phone - 340.774.2991 Fax - 340.774.6953 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 Superior 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 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. 01/2019 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. NOTARY PUBLIC COMMISSION RENEWAL FORM Rev. 01/2019 THE UNITED STATES VIRGIN ISLANDS OFFICE OF THE LIEUTENANT GOVERNOR 1105 King Street Christiansted, Virgin Islands 00820 Phone - 340.773.6449 Fax - 340.773.0330 5049 Kongens Gade Charlotte Amalie, Virgin Islands 00802 Phone - 340.774.2991 Fax - 340.774.6953 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. 01/2019 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 NOTARY PUBLIC COMMISSION RENEWAL FORM Rev. 01/2019 NOTARY BOND KNOW ALL MEN BY THESE PRESENT, that I, , Virgin Islands of the United States, as Principal; and of St. (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 St. , 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 NOTARY PUBLIC No. PRESIDING JUDGE Superior Court of the Virgin Islands NOTARY PUBLIC COMMISSION RENEWAL FORM Rev. 01/2019 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: _ NOTARY PUBLIC COMMISSION RENEWAL FORM Rev. 01/2019 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 whos 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. NOTARY PUBLIC MY COMMISSION EXPIRES NOTARY PUBLIC No. NOTARY PUBLIC COMMISSION RENEWAL FORM Rev. 01/2019 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: $ VALUE CO-SURETY(IES) SURETY SWORN AND SUBSCRIBED BEFORE ME THIS DAY OF , 20 . NOTARY PUBLIC MY COMMISSION EXPIRES NOTARY PUBLIC No. NOTARY PUBLIC COMMISSION RENEWAL FORM Rev. 01/2019 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 VIRGIN 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, COSTS, DEBTS AND SUMS 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/CITY/STATE/ZIP: 3. DATE OF BIRTH: 4. SOCIAL SECURITY No: 5. DRIVERS LICENSE No.: