California Notary Bond – Amount $15,000 Four-year coverage Name to appear on bond Requested effective date 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 The requested effective date, below, must be the same as the commission start date that appears on your Certificate of Appointment. Leave Blank for the effective date to be the same day it is issued. You may request to have your bond become effective at any date in the future, or up to 30 days prior. Mailing Address Bond will be delivered to the address below: Address Line 1 Address Line 2 City State Zip code County of Commission Contact number: Fax number E-mail address This notary surety bond only protects the public, not the notary (you). You should protect yourself with Errors and Omissions Insurance.