Kentucky Secretary of State
Michael G. Adams

Download the paper application Here:

Please enter the information below as it appears on your paper application. Required fields are denoted by an asterisk (*).

1)Enter your FULL LEGAL NAME as it is to appear on your commission certificate:

First Name*:

Middle Name:

Last Name:*

Name Suffix (i.e. Jr., Sr., III, etc.):

2) Date of Birth*:

3) Daytime Phone Number*:

4) Enter the home mailing address:

Address*:

City*:

State*:

Zip Code*:

6) Keep Mailing Address Private?

I would like to have my mailing address published on the Secretary of State Notary website.

A New Application
A Reappointment

5) County of Commission*:

The County of Commission above is the (choose one)*:

Kentucky county of residence.
Kentucky county where the applicant's principal place of employment is located.

7) Email Address*:

Re-enter your email address*:

8) Upload a scanned image of your paper application including your signature:

The uploaded file must be a PDF or TIFF image.