Notary Client Intake Form

I. Client Information

1. Client Name: [Client Name]

2. Client Address: [Client Address]

3. Client Email Address: [Client Email Address]

II. Identification Documents

1. Type of Identification: [Passport]

2. Identification Number: [A5678910]

3. Issuing Authority: [United States Department of State]

4. Expiration Date: [Date]

III. Transaction Details

1. Nature of Transaction: [Real Estate Sale]

2. Date of Transaction: [Date]

3. Parties Involved:

   • [Client Name]: Client

   • [Real Estate Agent Name]: Real Estate Agent

   • [Your Name]: Notary Public Services

IV. Notarization Requirements

1. Type of Notarization: [Acknowledgment]

2. Number of Signatures to be Notarized: [3]

3. Special Instructions: [Please ensure that all signatories provide valid photo identification.]

VI. Governing Law and Jurisdiction

This Notary Client Intake Form and any disputes arising from or related to it shall be governed by the laws of the State of [State], without regard to its conflict of law principles.

Any legal action or proceeding arising from or related to this Notary Client Intake Form shall be brought exclusively in the courts of the State of [State], located in the county of [County], and each party hereby submits to the jurisdiction and venue of such courts.

By signing below, I acknowledge that I have read and agree to the governing law and jurisdiction stated above.

Printed Name of Client: [Client Name]

Date: [Date Signed]

Printed Name of Real Estate Agent: [Real Estate Agent Name]

Date: [Date Signed]

Printed Name of Notary Public: [Your Name]

Date: [Date Signed]

Notary Seal (if applicable): [Seal]

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