NSA/NP's, PLEASE REGISTER BELOW THEN FAX COPIES OF THE
BELOW TO *(773) 289-0467

1. NOTARY COMMISSION CERTIFICATE
2.  E-n-O INSURANCE POLICY
3.  CURRENT W-9
First Name:
 Last Name:
Mailing Address:
 City, State, Zip.
Contact Number:
 Mobile:
 Fax No.
 Email:
Certified?
 YES
 NO
 Certified by:
 Certification Expires:
Are you an attorney?
 YES
 NO
 Attorney No.
 Licensed for which State?
Do you hold any other professional license:
Errors & Omissions Ins.
 YES
 NO
 If yes,  amount?
 Expires:
Check Days Available:
 M
 T
 W
 TH
 F
 Sat
 Sun
 24/7
 YES
 NO
List Times Available:
e.g., 9-5
Base Fee:
 E-Docs
 Fax Backs
 E-Closing Fee
Do you have an Electronic Signature/Stamp?
 YES
 NO
List Notary Memberships:
Any other additional information we should know about you?
Chicago Notary Services™
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© 2007-2010. ALL RIGHTS RESERVED.
An Illinois Notary Public is NOT a Notario(a) Publico(a), unless they are a  licensed attorney.
Independent contractors/agents, are not attorneys licensed to practice law and may not give legal advice
or accept fees for legal advice.
No somos abogados y no podemos dar consejo legal o collectar deniro para informacion legal.
Chicago Notary Services  can not represent you  before the United States Immigration and
Naturalization Service and/or the Immigration Board of Appeals.
Direct (773) 594-2874