Notary Public Bond Application

Notary Public Bond Application

Access through this program is available ONLY to MMIA member city/town employees. This is a service provided by Alliant Insurance Services, not the MMIA.
Are you currently a Notary?*

YesNo
Name as it appears on the commission*

First NameMiddle NameLast NameSuffix
Email*
example@example.com
Phone Number*

Area CodePhone Number
Address as it appears on the commission (notary stamp)
Address*

Street Address

Street Address Line 2

CityState

Zip Code
County of Residence*
Commission Effective Date

MonthDayYear
Date
Commission Expiration Date

MonthDayYear
Date
MMIA Member City/Town Name*
Do you acknowledge that you are submitting this application to purchase a $25,000 Notary Bond?*

YesNo
If you would like to purchase Notary Errors & Omissions coverage to protect you when performing your duties as a notary, please select the coverage amount. This coverage is separate, and in addition to, the notary bond.*

NONE$10,000$15,000$25,000
To complete the submission of this application, please click the SUBMIT button below. A copy of this submission will be sent to the email address entered above.

For questions regarding the application, the status of an application, or any other bonding questions, please contact:

Alicia Cortez
Assistant Account Manager
Alliant Insurance Services Inc.
Phone# 949-260-5099
Fax# 619-699-0906
Additional Remarks
Please enter the CAPTCHA phrase below to verify you are not a robot.*
Should be Empty: