Merritt Services, Inc.

NOTARY SIGN UP

Please Note: ALL fields are required. DO NOT leave any fields blank. If something does not apply, please add either “N/A” or “NONE.”

SIGNING AGENT INFORMATION

Full Name (Exactly what Appears on W9)

Company Name

Email Address

Address

City

Zip

Mailing/Payment Address

City

Zip

Best Contact Phone #

Alternate Phone #

Fax #

Cell #

EXPERIENCE / CERTIFICATION(S)

Signing Agent Since (year)?

# of Loan Signings?

# of Reverse Mortgage Signings?

# of ESIGN Loan Signings?

Please note any additional relevant experience, training, and/or certification(s):

COMMISSION / E&O / BACKGROUND INFORMATION

Background Check Co.

Background Exp Date

Notary Commission #

Commission Exp Date

E&O Ins Policy #

E&O Amount

E&O Ins Exp Date

Have you had any claims against you in the last five years relating to a RE transaction?

EQUIPMENT / PRINTING:

Are you able to download and print edocs from our secure website?

Are you able to fax docs after signing when required?

Laser Printer Brand/Model:

Dual Tray?

ADDITIONAL INFORMATION:

Distance willing to travel:

Availability - including state, counties and fees

Create a password

Confirm password

When you have completed ALL the information above, please click Add Me! below. You will receive a Success! message that your information has been submitted, and we will be notified via email that you have been added to our database. Please do NOT click this button more than once. Any updates can be made from the Notary Login section. After you receive the Success! message, please click Notary Login below, login, click Upload Credentials, and upload your credentials. Thank You!