C Exemption from Notary Public Study Course Requirements

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