Witness Services

Request for Witness Services
Date

MonthDayYear
Date
Admin ONLY:
For Office use ONLY- Clients, leave blank.
Section 1- Individual

Complete this section them move to section 3 if you are an individual requesting service.
Name

First NameLast Name
cw_client_name
cw_company_name
Phone
Please enter a valid phone number.Format: (000) 000-0000.
Email
Please enter a valid email
Section 2- Company/Entity/Third Party

Complete this section then section 3 if you are a company/entity/third party requesting service.
RC Mode (Hidden)
Company
Name of Company requesting service.
Company Phone
Company Email
Your Customer's Name (For Internal Reference Only)

First NameLast Name
cw_company_name
cw_client_name
Section 3

Please complete then submit your request.
Number of witness(es) needed
White Rose Notary Services LLC
Service Address
Service Address Re-typed
Please re-type to ensure accuracy
Fee/mile
parentSubmissionId
Document requires Witnesses
requestorCategory
jobType
Appointment
Witness Fee calculation
Agent Fee
*Witness fee: $35 per person + $0.725 per mile round-trip.*
Payment required in advance.
Scheduling Fee
Required prior to scheduling and will be subtracted from final fee. May pay full fee if desired.
How would you like to pay? (Single Choice)
override
White Rose Notary Services LLC
Please Add any other pertinent order details:
fbbnotary@gmail.com

USDDescription

Request for Witness Services