Notary Appointment Request Form
Name
*
First Name
Last Name
Age
*
Date of Birth
*
-
Month
-
Day
Year
Date
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Address where Notarization will take place
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do all Signers have an unexpired government issued ID?
Will any witnesses be present?
Yes
No
Requested Appointment Date and Time
What is the documents you want to be notarized?
You already have the document, is there a Notarial Acknowledgment already on it?
Yes
No
How many Signatures are needed to be notarized?
Please upload it here
Browse Files
Drag and drop files here
Choose a file
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Payment - Travel fee is due at booking, Notary fee paid on premises. We will send an invoice to your email.
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Travel Fee
1-3 miles
$
40.00
Quantity
1
2
3
4
5
6
7
8
9
10
Travel Fee
4-8 miles
$
50.00
Quantity
1
2
3
4
5
6
7
8
9
10
Travel Fee
10+ miles - $50 and up
$
100.00
Quantity
1
2
3
4
5
6
7
8
9
10
Payment Method
Please Select
Cash
Credit Card
Check
Wire Transfer
Bank Transfer
PayPal
Acknowledgment
Please check all.
I confirm that all information in this document is accurate and true.
I confirm that I'm at least 18 years old.
I confirm that I can read, write, and understand the English language.
I confirm that I have never been convicted for any offense.
I confirm that my professional license was never been revoked for any misconduct or similar.
I confirm that I am aware I must have ID present for all signers, and all must appear in person, before the Notary on day booked.
Signature
Date Signed
-
Month
-
Day
Year
Date
Submit
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