Notary Public Request Form

Notary Public Request Form

Use this form to request notarization services for one or more documents. Completion of this form does not constitute confirmation of an appointment; the notary will contact the requester to confirm availability and any required documentation or fees. The requester certifies by signature below that all information provided is complete and truthful.

Requestor Information

Notarization Details

Select the type(s) of notarial act requested (check all that apply):

Acknowledgment

Jurat (sworn statement)

Oath or Affirmation

Signature Witnessing

Copy Certification

Other (describe in Document Description)

Identification to be Presented

The requester must present current, government-issued identification that meets statutory requirements. Provide the anticipated form of identification:

Appointment Preference & Location

Mobile notary requested (travel fees may apply)

Fees and Payment Terms

The requester acknowledges responsibility for payment of all fees and travel charges associated with the requested notarial acts. Fees are payable at time of service unless otherwise agreed in writing.

Accepted Payment Methods Cash Check Card Invoice

Late Payment If invoiced amounts are not timely paid, a late fee of % per month or the maximum allowed by governing law will apply to outstanding balances. The requester will also be responsible for reasonable collection costs and attorney fees incurred in enforcing payment.

Consent, Certification, and Liability

By signing below, Requestor Name: certifies under penalty of perjury that the information provided on this form is true and correct to the best of the requester's knowledge and that the requester will present valid identification at the time of notarization.

The requester acknowledges that the notary is not providing legal advice and that the notary's role is limited to performing the requested notarial acts. The requester agrees to hold the notary harmless from liability arising out of false statements, misrepresentations, or the failure of the requester to provide required identification or documentation.

Confidentiality and Record Retention

The notary may retain a record of the notarial act as required by law. Such records will be maintained in accordance with applicable record retention requirements. The notary will treat personal information provided on this form as confidential to the extent required by law; however, the requester consents to disclosure if required by court order or by statute.

Governing Law & Entire Agreement

This Request Form and any agreements regarding performance of notarial services shall be governed by the laws of the State of without regard to conflicts of law principles. This form contains the entire agreement between the requester and the notary with respect to the subject matter herein and supersedes all prior or contemporaneous communications and proposals, whether electronic, oral or written.

Acknowledgment

By signing below the requester requests and authorizes performance of the notarial acts specified above and confirms acceptance of the fees and terms set forth in this form.

Sign Now