Colfax Group
   
   

712 Bancroft Road #138
Walnut Creek, CA 94598
(510) 250-5069
FAX (866) 457-6227
notary@colfaxgroup.com

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Registration Form

Simply complete the following notary application and a Colfax Group representative will contact you shortly. Once we have your information, you will be able to start receiving signing assignments. As a member of the Colfax Group certified network, you will receive updates as to new revenue opportunities, training information, and use of the Colfax Group notary center.

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Tell us about yourself  
   
Name (as appears on
your commission)
:

 

First:

Middle:

Last:

Company name:

Weekday address for document delivery:

Unit:

City:

State: Zip:

Saturday address for document delivery:

Unit:

City:

State: Zip:

Day phone:

( - ext.

Evening phone:

( ) -

Cellular:

( ) -

Pager:

( ) -

Fax:

( ) -

Email Address:

Driver License #:

 Exp Date: / (ie..mm/yy eg. )

Best way to contact you:

Nearest relative name:

Nearest relative phone:

( ) -

Have you ever been convicted of a felony or misdemeanor?

yes no

   
Service Information  
   
Distance (one-way)
you'll travel for $50:

Distance (one way)
you will travel beyond that for an additional fee?

Do you have any day, evening or weekend restrictions?

Is UPS Saturday delivery of documents available to you?

yes no

   
Experience  
   
How long have you been a notary?

Have you notarized loan documents?

yes no

If so, how many?

Do you have loan signing experience with (select all that apply):

purchases
refinances
lines of credit
fixed 2nd/3rd

List 3 signing services you currently work for?



Notary Commission & Insurance
Notary commission number:

Expires:

/ / 20

Bond Certificate number:

Amount:

Expires:

/ / 20

E & O Insurance number
(if applicable)

Amount:

Expires:

/ / 20

Skills
Are you bilingual? yes no
Languages:



Additional Licenses
To what associations do you belong:



Equipment

Have you printed a set of loan documents via email? yes no

If yes, Approximately how many?

Do you have a laser printer? yes no
Are you capable of printing on legal size paper? yes no
Make and model of printer

Accounting

SELECT:
Social Security #
     OR
Tax ID #
SSN#: - -
TIN#: -
Make checks payable to:
Address check is to be sent to:

Unit:

City:

State: Zip:

How did you hear about us?

Please review the following conditions

Accept


Please make sure that you have completed all questions & then submit.
Thank you for completing this form.

 

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