Disponible en français35-026E (2016/04) © Queen's Printer for Ontario, 2016

Ministry of Government and Consumer Services

Notary Public Application - Solicitors Only

Fee $145.00 PLEASE ENCLOSE WITH APPLICATION AND MAKE CHEQUE OR MONEY ORDER PAYABLE TO THE MINISTER OF FINANCE

Date (yyyy/mm/dd)

Return to: Official Documents Services Business Development and Services Branch Ontario Shared Services Ministry of Government and Consumer Services 222 Jarvis St, Main Floor Toronto ON M7A 0B6

I,(Print Name)

hereby make application to be

appointed a NOTARY PUBLIC in and for the Province of Ontario.

I was called to the Bar on the day of , .

My name identically as shown on the Rolls and records of the Law Society of Upper Canada.

If you have a name change on the Rolls and records of the Law Society of Upper Canada, print or type your new name and date of name changed in the space provided below.

Applicant's Name Date of Name Change (yyyy/mm/dd)

If you have any questions, please call 416 325-8416.

Signature Date (yyyy/mm/dd)

Name of Organization

Mailing AddressUnit Number Street Number Street Name PO Box

City/Town Province Postal Code

Telephone Number Work Number Email Address (if available)

Note: Your embossed Notarial Seal should be ordered from a Seal Company after you have received your Certificate from this office. The Seal must match the name as we have set it out on the Certificate and also show Notary Public and Ontario.

Personal information is collected under the legal authority of the Notaries Act, R.S.O. 1990, c.N. 6 and will be used for mailing purposes. Official Documents Services keep a record of all the Notaries Public in the Province of Ontario. For further information regarding the collection, please contact Manager, Official Document Services, Ontario Shared Services, Ministry of Government and Consumer Services, 222 Jarvis St, Main Floor, Toronto ON M7A 0B6. Telephone 416 325-8416.