Client Intake Form for Melanie B Notary 📝✨
Please fill out this form to schedule your notarization appointment and provide necessary details.
First Name
*
Last Name
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Preferred Contact Method
Please Select
Phone Call
Text Message
Email
Any
Best Time to Reach You
Please Select
Morning 8am-12pm
Afternoon 12pm-5pm
Evening 5pm-8pm
Any Time
Type of Document(s) to be Notarized
*
Please Select
Real Estate/Deed
Loan/Mortgage Documents
Power of Attorney
Will/Trust/Living Will
Affidavit/Sworn Statement
DMV/Vehicle Title Transfer
Business/Corporate Documents
Medical/Healthcare Directive
Immigration Documents
Court/Legal Documents
I-9 Employment Verification
Financial/Bank Documents
Other
Number of Documents
Please Select
1
2
3-5
6-10
10+
Number of Signers
*
Please Select
1
2
3
4+
Will Witnesses Be Required?
Please Select
No
Yes - signer will provide
Yes - we will provide one
Yes - can you assist?
Service Type
*
Please Select
Mobile - Come to Me
In-Person - Meet at Location
Remote Online Notarization RON
Preferred Date
-
Month
-
Day
Year
Date
Preferred Time of Day
Please Select
Morning 8am-12pm
Afternoon 12pm-5pm
Evening 5pm-8pm
Flexible/No Preference
Urgency
Please Select
Standard - A few days is fine
Soon - Within 1-2 days
Same Day/ASAP
Signing Location Type
Please Select
My Workplace/Office
Hospital/Care Facility
Attorney's Office
Real Estate/Title Office
Coffee Shop/Public Place
Other
N/A Remote/Online
Signing Address or General Area
Type of ID Signer(s) Will Present
*
Please Select
Driver's License
State ID Card
U.S. Passport
Military ID
Permanent Resident Card
Foreign Passport
Not Sure/Need Guidance
Does Any Signer Need an Interpreter?
Please Select
No
Yes - We will provide one
Yes - Can you assist?
Does Any Signer Have a Physical Limitation?
Please Select
No
Yes - Signature by Mark needed
Yes - Other accommodation needed
Are All Signers Mentally Competent to Sign?
Please Select
Yes
No - Please contact me to discuss
Not Sure
How Did You Hear About Melanie B Notary?
Please Select
Google Search
Friend/Family Referral
Attorney or Title Company
Social Media
Repeat Client
Other
Preferred Payment Method
Please Select
Cash
Zelle
Venmo
CashApp
Credit/Debit Card
Check
Invoice/Billed
Additional Notes or Special Instructions
I confirm that all information provided is accurate, all signers will be present at the time of notarization, and I understand that documents must not be signed prior to the notary's arrival.
*
I agree
Submit
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