Field Service Intake Form

Notary Specialty Service Request

Please complete the form below to request a mobile or remote marine notary appointment. Once we review your request, we'll contact you to confirm availability, review your documents, and provide an estimated quote.
Requestor Full Name

First NameLast Name
Email Address
example@example.com
Business Name (if applicable)
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Preferred Method of Contact
What service do you need?
Who are you?
Select Services Needed

Other
Preferred Service Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
What service do you need?
Vessel Name
Vessel Information

MakeModel
YearLength
Hull Identification Number (HIN)
Documentation Number (if applicable)
Registration Number (if applicable)
How many Signers?
Where will the signing take place?
Appointment Address (If in person notary request)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you requesting this appointment on behalf of a client?
If yes, please fill out. Client NameClient EmailClient PhoneCompany NameInternal File Number / Closing NumberPreferred Invoice Recipient(optional)
Where is the signer currently located? country, state/province

Do all signers have:

Rows	Ready ✓	No, Need Help
Government-issued photo ID (Not Expired)
Computer, tablet, or smartphone with camera
Internet connection
Active Email address
Eligible to complete identity verification (Knowledge-Based Authentication & credential analysis)

Please Note: Passing identity verification cannot be guaranteed in advance. Eligibility depends on your available U.S. identity records and successful credential analysis during the notarization session. If identity verification cannot be completed, the Remote Online Notarization cannot proceed, and alternative notarization options may be discussed.
Please upload your unsigned documents.
File Upload

Cancelof
Witnesses
Does your document require witnesses?
If yes, How many?
Need Help Coordinating Witnesses? ⭐
Preferred Appointment
How soon do you need your notarization?
How soon do you need your notarization?
Additional Services
Please provide any additional information that will help us prepare for your appointment."
Acknowledgements
☐ I understand documents should remain unsigned until instructed by the notary unless otherwise directed by the receiving agency.

☐ I understand pricing is based on the number of notarial acts, travel (if applicable), and requested services.

☐ I understand the initial quote is an estimate and may change after document review. Any changes will always be explained before services are completed.

☐ For Remote Online Notarization, I understand all signers must successfully complete the required identity verification process before the notarization can proceed.

☐ I certify that the information provided is accurate to the best of my knowledge.
Should be Empty:

Notary Specialty Service Request