Application to Produce or Manufacture Notary Seals

STATE OF CALIFORNIA

SECRETARY OF STATE

APPLICATION TO PRODUCE OR MANUFACTURE NOTARY PUBLIC SEALS

(Read instructions provided on back before completing this application - TYPE OR PRINT IN INK)

Check the appropriate box or boxes below for the type of seal(s) you will produce:

FOR SECRETARY OF STATE USE ONLY

ID NUMBER ______________

______________ START DATE

Rubber Stamp Electronic Seal

Check here if you do not wish to be included on the list

of approved seal manufacturers. (See Note in Instructions.)

SEAL MANUFACTURER

NAME OF BUSINESS ______________________________________________________________________________

BUSINESS ADDRESS _____________________________________________________________________________

CITY___________________________ STATE/PROVINCE _________________ ZIP CODE ______________________

COUNTRY (IF OUTSIDE US) ________________________________________________________________________

BUSINESS TELEPHONE NUMBER (_____) _____________ EXT __________ FAX NUMBER (_____) ____________

PERSON RESPONSIBLE FOR COMPLIANCE WITH LAW, PROCEDURES AND GUIDELINES

FIRST NAME ___________________ MIDDLE NAME ____________________ LAST NAME ____________________

ADDRESS _______________________________________________________________________________________

CITY___________________________ STATE/PROVINCE _________________ ZIP CODE ______________________

COUNTRY (IF OUTSIDE US) ________________________________________________________________________

TELEPHONE NUMBER (____)___________________________ E-MAIL ADDRESS _____________________________

I, the undersigned, hereby certify that the information contained in this application is true and complete to the best of my

knowledge. I also certify that I have read fully and understand the relevant law regarding the production or manufacture

of notary public seals in California and the Procedures and Guidelines for the Issuance of Notary Seals. I agree to

exercise reasonable care to ensure that the provisions of those procedures and guidelines and relevant laws are

complied with.

_________________________________________________ ________________________________________

Signature of Responsible Person Date

_________________________________________________

Typed or Printed Name

Rev. 04/02/07

Instructions To Become an Authorized Seal Manufacturer

1. Review the "Procedures and Guidelines for the Issuance of Notary Public Seals" and the

Government Code Section 8207 et. seq. that are enclosed. Persons not complying with the law

are subject to civil penalties of $1,500 for each violation pursuant to Government Code Section

8207.4.

2. Complete the application on the reverse side. Indicate by checking the appropriate box on the

application whether you will manufacture rubber stamps, electronic seals, or both.

3. Mail the completed application, along with the following items, to the Secretary of State, Business

Programs Division, Notary Public & Special Filings Section, Post Office Box 942877, Sacramento,

CA 94277-0001:

•

The application fee of $50.00. If paying by check, please make check payable to the

"Secretary of State."

• A photographic sample of a seal that contains the required elements and meets the size

specifications under Government Code section 8207. You may use "XXX1" as a generic

identification number. Sample seals have been included in the enclosed procedures and

guidelines.

• If you are applying to manufacture an electronic seal, please provide a description of the

process that will be used to meet the requirements set forth in the guidelines. A demonstration

of your process may be required.

4. Once you have submitted the applicable materials as described above, we will review your

application. If your application is approved, you will be issued an identification number via

facsimile letter, with original letter to follow in the mail.

Note: If your application is approved, your business name will be included on the list of authorized

seal manufacturers that is included in the commission packet sent to all newly commissioned

notaries. If you do not want to be contacted directly by a notary to have a seal manufactured,

please check the appropriate box on the application.

If you have any questions concerning the application, this process, the law, or the procedures and

guidelines, please contact the Notary Public Section by telephone, (916) 653-3595, or by FAX,

(916) 653-9580.

Rev. 04/02/07