Notary & Document Assistance Request Form
📍 Base Office: 2323 W 5th Ave, Columbus, OH 43204 🕒 Available: In-Office | Mobile | Remote
Section 1: Contact Information
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Preferred Contact Method
*
Please Select
Email
Phone
Section 2: Select Service Type
Type a question
*
Document Assistance Only
Notarization Only
Both (Document Assistance + Notarization)
Section 3: Document Assistance (Fill-Out Help)
What documents do you need help filling out?
*
W-4 – $30
W-9 – $30
1099-NEC – $35
I-9 Employment Verification – $40
Lease Agreements – $50
Power of Attorney (Completion only) – $60
Medical Forms – $25
Other - $30
None
Other ( Document Description)
Section 4: Notarization Request
Select the document you need notarized:
*
Please Select
Power of Attorney - $55
Affidavit -$30
Real Estate/Loan Docs – $125
Business Contract – $30
Vehicle Title/Bill of Sale – $30
Parental Consent/Travel Form – $25
Cannabis-Related Forms – $60
Other (Specify Below) – $45
Describe "Other":
Upload Document(s) (Optional)
Browse Files
Drag and drop files here
Choose a file
Cancel
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Section 5: Type of Notarization
Location
*
In-Office (No travel fee)
Mobile (We come to you)
Remote Online Notarization (RON)
Section 6: Travel Distance Fee (Only for Mobile Notary)
If mobile service selected, please estimate your location distance from 2323 W 5th Ave, Columbus OH 43204
Travel Distance from Office
*
Please Select
Level 1 (0–15 miles) ➡️ $25
Level 2 (15–30 miles) ➡️ $50
Level 3 (30-45miles) ➡️ $75
Level 4 (45+ and up) $100
Level 5 (Remote only)
📝 Note: Travel fees apply in addition to notarization/document fees.
Section 7: Additional Details
Appointment
*
Section 8: Auto Calculation & Total Cost Summary
Total Summary Includes:
*
Section 9: Payment
Payment Method
*
prev
next
( X )
USD
Total Amount Due
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
Section 10: Consent & Signature
Acknowledgment Checkbox:
*
I understand the total cost includes service type(s) selected, and full payment is due before services are rendered.
Signature
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit & Pay Now
Submit & Pay Now
Should be Empty: