Notary Intake Form

I. Client Information

1. Full Name: [Client's Name]

2. Email Address: [Client's Email Address]

3. Phone Number: [Client's Phone Number]

II. Document Details

1. Nature of Document: [Real Estate Purchase Agreement]

2. Number of Pages: [10]

3. Date of Document: [Date of Document]

4. Additional Comments: [This agreement outlines the terms and conditions of the purchase of [Property Address], including the sale price, contingencies, and responsibilities of both the buyer and seller.]

III. Identification

1. Type of Identification: [Driver's License]

2. Identification Number: [123456789]

3. Issuing Authority: [Department of Motor Vehicles (DMV)]

4. Date of Expiration: [Expiration Date]

IV. Notary Services

• Preferred Appointment Date: [Preferred Date for Notarization Appointment]

• Preferred Appointment Time: [Preferred Time for Notarization Appointment]

• Location: [Preferred Location for Notarization]

• Additional Services:

• Witnessing Signatures

• Administering Oaths

• Certifying Copies

V. Signature

By signing below, I acknowledge that the information provided in this form is true and accurate to the best of my knowledge.

This Notary Certificate constitutes the entire agreement between the parties and supersedes all prior and contemporaneous agreements, understandings, negotiations, and discussions, whether oral or written.

Printed Name of Client: [Client Name]

Date: [Date Signed]

Printed Name of Notary Public: [Your Name]

Date: [Date Signed]

Notary Seal (if applicable): [Seal]

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