Select 1 of 2 Identification Options OPTION 1: Use a A National (Federal) Government Photo ID as your primary form of identification. – To receive a national government ID, you completed a careful screening Type of Document Circle One process. Hence only one Class A photo ID is needed to prove your identity. (e.g., passport) Photo: Y N Examples are passport or national driver’s license such as those issued in Photo Required the UK or EU. Issued By #1 ID / 1 ID Number Expiration Date: Must not be expired. OPTION Name Appearing on ID Document Questions about ID’s or filling out the form? Contact: 1.855.277.9993 OPTION 2: Use a CLASS B Reputable Photo ID as your primary form of identification and a second ID. – Type of Document Circle one The primary ID must be a photo ID such as driver’s license, employee ID with photo or a credit card with photo. #1 (e.g., driver’s Photo: Y N ID license) Photo Required / 2 Issued By OPTION ID Number If using credit card, Questions about ID’s or filling out the form? Expiration Date: provide last 4 digits Contact: 1.855.277.9993 Must not be expired Name Appearing on ID Document Since there was less screening than Class A to receive a Class B ID, a second Type of Document Circle One ID must be presented. The second ID may be Class B or Class C. (e.g., credit card) Photo: Y N Photo Optional 2 Class C is an ID issued by a reputable party without a photo. Social Security # Issued By Card or Credit Card without a photo are Class C ID’s. ID / 2 ID Number Questions about ID’s or filling out the form? If using credit card, Expiration Date: Contact: 1.855.277.9993 provide last 4 digits OPTION Must not be expired Name Appearing on ID Document GO TO NEXT PAGE OF FORM TO COMPLETE Applicant Name: Applicant ID Number:
Select 1 of 2 Identification Options OPTION 1: Use a A – National (Federal) Government Photo ID as your primary form of identification. OPTION 1 / ID #1 Type of Document (e.g., passport) Circle One Photo: Y N Photo Required To receive a national government ID, you completed a careful screening process. Hence only one Class A photo ID is needed to prove your identity. Examples are passport or national driver’s license such as those issued in the UK or EU. Questions about ID’s or filling out the form? Contact: 1.855.277.9993 Issued By ID Number Expiration Date: Must not be expired. Name Appearing on ID Document OPTION 2: Use a CLASS B – Reputable Photo ID as your primary form of identification and a second ID. OPTION 2 / ID #1 Type of Document (e.g., driver’s license) Circle one Photo: Y N Photo Required The primary ID must be a photo ID such as driver’s license, employee ID with photo or a credit card with photo. Questions about ID’s or filling out the form? Contact: 1.855.277.9993 Issued By ID Number If using credit card, provide last 4 digits Expiration Date: Must not be expired Name Appearing on ID Document OPTION 2 / ID # 2 Type of Document (e.g., credit card) Circle One Photo: Y N Photo Optional Since there was less screening than Class A to receive a Class B ID, a second ID must be presented. The second ID may be Class B or Class C. Class C is an ID issued by a reputable party without a photo. Social Security Card or Credit Card without a photo are Class C ID’s. Questions about ID’s or filling out the form? Contact: 1.855.277.9993 Issued By ID Number If using credit card, provide last 4 digits Expiration Date: Must not be expired Name Appearing on ID Document GO TO NEXT PAGE OF FORM TO COMPLETE Applicant Name: Applicant ID Number:
UIS_Notary_Form_v2%204%203.docx