Legacy Club Application - Florida Notary

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Legacy Club Application

Thank you for your interest in our Legacy Club program.

Please complete and sign the application below. Optionally, you may download the application to complete offline and email it to mail@flnotary.com.

We look forward to connecting with you about your company’s notary needs!

Contact

Company*
Email*
Company Contact Name*
First Last
Title
Department
Phone*
Cell Phone
Company Address*
Street Address City State ZIP Code
Preferred Payment Method*
- Credit Card
- Purchase Order
- Check
Estimate # of Applicants:*
- 3 or more
- 10 or more
- 25 or more

Signer

Authorized Signer
First Last
Signer Title
Signer Department
Signer Phone
Signer Cell Phone

TERMS AND CONDITIONS

Discount applied when notary applications are submitted within 1 year of signed contract.
- SAVE $5 - 3 or more notary applications submitted.
- SAVE $10 - 10 or more notary applications submitted.
- SAVE $15 - 25 or more notary applications submitted.
Payment:
- Acceptable forms of payment: checks, purchase orders, or credit card.
- Payment or purchase order must be submitted with each application.
- Purchase order payment(s) due within 30 days of invoice.
AGREEMENT

I hereby attest that I am a legal representative for my company, and I am duly authorized to agree to the Legacy Club’s Terms & Conditions as outlined above. Inaccurate information cited in this agreement makes the aforementioned Terms & Conditions null and void.

Signatures

Contact Signature*
Signer Signature
Date*
MM slash DD slash YYYY

Name
This field is for validation purposes and should be left unchanged.

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