South Carolina State forms

Notarystation.net
| 1213 TRACK ROAD
PELION SC 29123
Chad Moore Notary Public Of south Carolina
Mobile Notary Public
Client Intake Form
Name: ______________________________
Date: __________________
Address: _____________________________________________________________________
City:
_______________________________ State: _________ Zip Code: _________________
Phone: __________________________ Email: _______________________________________
How did you hear about us? _______________________________________________________
Type of Notariz
ation: ____________________________________________________________
Fee Agreed Upon: _______________ + Travel Base Rate: _______________
+
Total Miles Traveled: _____________ =
$
_______________
(Round Trip)
$0.75 per mile
Payment Method: Cash Check _____________ Money Order Credit/Debit
Please note there will be a 4
% convenience fee for all credit/debit transactions
Discount Applied: __________________ Veteran Emergency Services
Grand T
otal Paid
: ________________
Client Signature: _________________________________ Date: ________________