I-9 Service Request
Use this form to schedule an authorized representative to complete Section 2 of the federal Form I-9 for remote employment verification. This service does not include notarization unless specifically required by your employer.
Submission Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Who is completing this form
*
Individual
Entity ( Company/Business, Title, etc)
Name
*
First Name
Last Name
Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
fbbnotary@gmail.com
Company Name
*
Name of Company requesting service.
Company Phone
*
Company Email
*
Company Contact Person
*
Your client's Name (For Internal Reference Only)
*
First Name
Last Name
Your Client's Phone ( Helps with scheduling)
Your Clients Email (Helps with scheduling)
cw_client_name
cw_company_name
RC Mode (Hidden)
RC Mode: {rc_mode}
Select/Input Other Services being Requested
*
I-9 Service
Give us more details so we may best serve you:
Service Location
*
Travel Fee
Travel Fee Calculated
Please Re-Type FULL service Address
*
please input service address again to ensure accuracy.
I-9 Appointment
*
Fee to Schedule
Required at least 2 hours before appointment to avoice forfeiting appointment. Deducted from full service fee.
Payment Method-Individual
*
Cash App- no processing fee ( $whiterosenotary)
Apple Pay no processing fee (301-830-0043)
Zelle - no processing fee (301-830-0043)
Venmo + processing fee (@whiterosenotary)
Credit Card Scheduling Fee Only (+processing fee)
Credit Card( + processing fee)
Payment Method-Entity
*
Cash App- no processing fee ( $whiterosenotary)
Apple Pay no processing fee (301-830-0043)
Zelle - no processing fee (301-830-0043)
Venmo + processing fee (@whiterosenotary)
Credit Card( + processing fee)
Company Portal/Internal Billing- no processing fee
Company Check- no processing fee
Override
Approved Fee
Credit Card Scheduling Fee
Venmo Scheduling Fee
Scheduling Fee Due
Venmo Total Due
Credit Card Total Due
Service Estimate Total
Parking Fee will be added to the total at the appointment when appropriate.
White Rose Notary Services
Stripe
Service Fee
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( X )
USD
Description
Debit or Credit Card
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
Expiration Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Expiration Year
Revised?
No
Yes
Revision Reference ID
Submit
Should be Empty: