Notary Appointment Request Form

MikesNotary4U Appointment Request Form
Greetings! I am delighted that you have chosen me to handle your notarization needs. To ensure a seamless service, please complete the request form below.

RATES: CASH/CHECK/MONEY ORDER/CASH APP (NO DEBIT CARD/CREDIT CARD)
- Single Document (Wet Signature and Stamp) $10.00
- Each Additional Document (Wet Signature and Stamp) $5.00
- Each Additional Wet Signature/Stamp $5.00
- E-Notary- $25.00 (Must select E-Notary)

All signers must be present, with a valid photo ID and required documents. If you do not have photo ID, I will not be able to notarize the documents for you. Payment will be due at time of signing. As a notary, I reserve the right to refuse to sign or abort the signing if the need arises. In the event of an aborted signing, payment will be refunded to you.

AS OF 10/09/2024, PLEASE CALL OR TEXT ME AT 479-857-0272 FOR APPOINTMENT SCHEDULING DUE TO ME BEING DISPLACED FROM MY OFFICE TEMP.
Name

First NameLast Name
Age
Date of Birth

MonthDayYear
Date
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Requested Appointment Date and Time
What is the file(s) you want to be notarized?
Please upload it here (This is required for E-Notary Services)

Cancelof
Payment*
prevnext( X )
Single Document(Wet Signature and Stamp)
$10.00 Quantity



Additional Documents(Wet Signature and Stamp)
$5.00 Quantity



Stamp ONLYThis would be for a document that just requires a notary's stamp
$5.00



Signature ONLYThis would be for a document that just requires a notary's signature (witness).
$5.00



E-NotaryI will reach out to you via email once form is submitted for further details on E-Notary
$25.00



Total

$0.00
Payment Method
Payment will be due at the time of signing, NOT form submission.
Acknowledgment
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 understand that I must be present with a valid photo ID at the time of signing
Signature

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Date Signed

MonthDayYear
Date
Should be Empty:

MikesNotary4U Appointment Request Form

Acknowledgment