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Client Information

Full Name*
Email*
Phone*

Appointment Details

Appointment Address*
State* Select state MACATXNY
Date*
Time*

Number of Witnesses None 1 Witness ($40) 2 Witnesses ($90) 3 Witnesses ($150)
Rush / After-Hours Options
Rush Appointment (+$100)
After-Hours/Weekend (+$50)
Last-Minute Booking (<2 hrs) (+$75)
Upload ID or Payment Screenshot

Payment

Please make your deposit or full payment using any of the options below:

• CashApp: $KMobileNotaryService
• Venmo: @kelly-mobile-notary-services
• Zelle: 774-826-5193
• Square Secure Checkout

Payment Method Used* Select Zelle Venmo CashApp Square

Summary

Total Fee: $[auto-calculated]

Deposit Due: $[50% or 100% logic]

Notes or Special Requests

📄 Cancellation & Reschedule Policy

✔️ Reschedule 24+ hrs: FREE
✔️ Reschedule < 24 hrs: $40
❌ Cancel < 2 hrs: 50% fee applies
❌ Cancel after notary dispatched: No refund
➕ 1-time fee waiver for loyal repeat clients

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