NAC240.264. Nonresident applicant for appointment as notary public: Form of affidavit confirming applicant’s employment within State of Nevada if applicant not self-employed.

The following form must be used by the employer an applicant for appointment as a notary public who resides in an adjoining state if the applicant is not self-employed:

NONRESIDENT NOTARY PUBLIC

AFFIDAVIT OF EMPLOYER OF APPLICANT

STATE OF.............................

COUNTY OF........................

     I, ....................(Name of Employer)...................., being first duly sworn, state upon personal knowledge and under penalty of perjury as follows:

     1. My business, ....................(Name of Business)...................., is licensed to do business in the State of Nevada.

     2. The address of my place of business is...................................................................................

............................................................................................................................................................

     3. The telephone number at my place of business is....................................................................

     4. ....................(Name of Employee/Applicant).................... is regularly employed at my place of business within the State of Nevada.

DATED this..........(day) of....................(month) of......(year)

                                                                        ....................................................................................

                                                                                                Signature of Employer

Signed and sworn to before me on .......(date).......by..........(Signature of Employer)........................

                                                                        ....................................................................................

                                                                                             Signature of Notary Public

     (Added to NAC by Sec’y of State by R175-97, eff. 1-20-98)