ORDER FORM

We carry a full line of the supplies that are REQUIRED BY LAW for the Texas Notary Public . You may print out this page and mail in your order with a check or fax it to us with credit card information.

U P S Business Delivery 2-5 Days

FREE Texas Notary Public Handbook with order!

Price

Quantity

Total

Required by Law

Indicate Seal Choices!

Complies with new laws effective: 9-1-01

Metal Embosser 1

$22.95

____________________

Pre-Ink Stamp

$19.95

____________________

Regular Rubber Stamp

$16.95

____________________

Self-Ink Stamp

$20.95

____________________

Jurat Stamp

$14.95

____________________

Acknowledgment Stamp

$14.95

____________________

Record Book & Fee Chart

$12.95

____________________

Frame Certificate

$20.95

____________________

Bureau Program (2-Year)

$24.00

____________________

Impression Inker

$10.95

____________________

Shipping & Handling

$6.00

Total

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1 [    ] Substitute Round Pre-Ink Stamp

(Term must correspond to years remaining on commission)

Print or type the requested information

[    ] Check enclosed-Payable to Texas State Notary Bureau

Please charge $______________ to the following credit card:
[    ] VISA [    ] Mastercard [    ] Discover [    ] American Express

NAME ON CREDIT CARD: _________________________________________________________________

SIGNATURE: ___________________________________________________________________________

CREDIT CARD NO. ______________________________________________________________________

CARD EXPIRES: ________________________________________________________________________

Notary Name __________________________________________________________________________
(Seal is made with notary name indicated)

Company Name _________________________________________________________________________

Commission Expiration Date: __________________________________________________________

Business Address _____________________________________________________________________

Social Security Number: ______________________________________________________________

City/State/Zip _______________________________________________________________________

Telephone ( __________ ) _____________________________________________________________

(UPS Delivery is not guaranteed or insured)

Mail application and payment to
Notary Insurance Services, Inc.
4107 South 1st Street
Austin, Texas 78745

Or, you can fax your order to 512-707-7115

Form 1761-10-98

  © 2003 Texas State Notary Bureau    All rights reserved