Mobile Notary Appointment Intake Paperwork
Contact Name (person ordering the notary appointment)
*
First Name
Last Name
Contact Phone Number (person ordering the notary appointment)
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Signer's Name (if different than contact name)
First Name
Last Name
Signer's Phone Number (if different than contact number)
Please enter a valid phone number.
Format: (000) 000-0000.
How many signers will be signing the documents?
Extra Notes to list additional signers / numbers (if necessary)
What kind of document(s) are you needing notarized? (Will, Power of Attorney, etc)
*
How many documents are you needing notarized? (An exact number or range/estimate is acceptable)
*
Is the document already prepared?
*
Yes
No, I need someone to make the document for me
I am not sure
Is the document already printed?
*
Yes
No, I need the notary to print the document for me
I am not sure
Does the document require witnesses?
*
Yes
No
I am not sure
The document is a Last Will and Testament (automatic yes)
Your document requires witnesses. Do you have witnesses available or do you need us to provide witnesses?
I am not sure yet.
I have all the witnesses that I need available for the appointment.
I have one witness available, but I need an additional witness provided for me.
I do not have any witnesses available and need 1 provided for me.
I do not have any witnesses available and need 2 provided for me.
Your document requires witnesses. Do you understand that the witnesses should be neutral 3rd parties and not benefiting from the document in any way? (Example: If the document is a will, a witness should not be inheriting anything in the will.)
I understand.
*VERY IMPORTANT* Does the witness/witnesses have VALID (unexpired) identification, such as a Driver's License, State Identification Card, or Passport? (It does not have to be from Texas. It just needs to be issued by a state or federal government, include their name, and a picture in order to be qualify.)
I am not sure yet.
Yes, I am sure that my witness/witnesses have valid ID and I have confirmed that they will have it with them at the appointment time.
My witnesses do not have ID. I need to find different witnesses or ask that they be provided for me.
Have you chosen an exact location (address) for this appointment? (Do you know where you want to meet?)
*
Yes, I have an exact address.
I only know the city/town but have not chosen the exact location / address.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is the appointment location a health care facility (hospital, nursing home, rehab, assisted living, etc)?
Yes
No
What is the name of the facility? (BSA Hospital, Northwest Hospital, etc)
What room number do you want the notary to meet you at?
What city, town, or side of town (example: Downtown Amarillo) do you need to have your appointment?
What day / time? (Example: ASAP, on Monday between noon and 3pm, Tuesday June 1st at 4pm, etc)
*
*VERY IMPORTANT* Does the signer have VALID (unexpired) identification, such as a Driver's License or State Identification Card? (It needs to be issues by a state or federal government, include their name, and a picture in order to be qualify.)
*
Yes
No
I'm not sure
Can you provide some type of credible witness (someone with valid ID as described above) who is willing to swear under oath that the signer is who they claim to be in the document?
Yes
No
Maybe / not sure
Are we leaving the document with the signer or do we need to ship it somewhere?
*
Leave it with the signer / someone else at the appointment
We need it shipped. I will provide information below.
We need it shipped and we also need a scan of the document before it is shipped. I will provide information below.
We only need an electronic copy / scan of the document after completing. I will provide scanback information (who to email the file to) below.
Shipping & Scanning notes / Other notes / anything else we should know:
Who will be paying for the service and where should we send the bill? (name + phone number or email address)
You may upload your file here if you need it printed.
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