White Rose Notary- Other Services
Admin ONLY:
For Office us ONLY- Clients, leave blank
Submission Date
-
Month
-
Day
Year
Date
Section 1- Individuals
Complete these items then move to section 3 if you are an individual seeking service.
Name
First Name
Last Name
Phone
Please enter a valid phone number.
Email
example@example.com
fbbnotary@gmail.com
Section 2 Entity/Company/ Third Party
Complete these items then move to section 3 if you are an entity/company/third party seeking service.
Company Name
Name of Company requesting service.
Company Phone
Company Email
Your client's Name (For Internal Reference Only)
First Name
Last Name
Name Unified
cw_client_name
cw_company_name
RC Mode (Hidden)
RC Mode: {rc_mode}
Section 3
Please complete then click submit.
Select/Input Other Services being Requested
*
Vehicle Inspection /Transfers
Other
Other
Give us more details :
Service Address 1
*
Service Address 2
*
please input service address again to ensure accuracy.
Appointment
*
Approved Fee
Agent Fee
Scheduling Fee
Required prior to scheduling and will be deducted from final fee. May pay full fee below if preferred,
How would you like to pay?
*
Cash
Cash App (submit in app using $whiterosenotary)
Apple Pay (submit on phone using 301-830-0043)
Google Pay (submit using fbbnotary@gmail.com)
Zelle (submit in app using 301-830-0043)
Venmo (submit in app using @whiterosenotary)
Credit Card
Company Portal/Internal Billing
Pay Later/Invoices (Approved Entities ONLY)
Override
White Rose Notary Services LLC
Service Fee
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next
( X )
USD
Description
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit
Should be Empty: