Section 176.ILLUSTRATION C   Exemption from Notary Public Study Course Requirements

Name:                          _________________________________________________________

Street Address:           _________________________________________________________

City, State, Zip code:  _________________________________________________________

I am:  (check one)

____    An Illinois licensed attorney in good standing with the Illinois Attorney Registration and Disciplinary Commission.  My ARDC registration number is ________________.

____    Currently employed by an Illinois licensed attorney (e.g., law firm located in Illinois, Illinois State's Attorney's Office, Illinois Public Defender's Office, Illinois Attorney General).

Name and address of firm or agency: _____________________________________________

_____________________________________________

_____________________________________________

Name of Illinois licensed attorney who is my direct supervisor: _____________________________________________

____    Currently an Illinois court or federal court judge or employed by an Illinois or federal court.

Name and address of the court: ______________________________________________

______________________________________________

______________________________________________

I have read and understand the version of the Act that is in effect at the time of this application and certify that the above information is true and accurate.

________________________________

Signature

________________________________

Date

(Source:  Added at 49 Ill. Reg. 584, effective January 1, 2025)