form be notarized?
The Data Banks require notarization of the self-query request form to deter fraud and protect the privacy of sensitive and confidential information requested by practitioners, providers, and suppliers. A notarized copy ensures the Data Banks that the individual submitting the self-query form has requested the information on behalf of himself, herself, or their organization. As such, the self-querier and the notary public must sign and date the self-query form before the Data Banks can process the request. In addition, the notary must also provide a commission expiration date and affix a notary seal. If the notary public does not have a stamp or seal, an alternative proof of office must be provided (e.g., a copy of a notary certificate). The only lawful date on a notarial certificate is the date the signer actually appeared. • How do I correct my address in a Data Bank report? The Data Banks cannot change information submitted in reports; however, if you are the subject of a report in t