Closing Agents Affiliate Application

* Required fields

*Name

*Company

*Address

*City

*State

*Zip

*Fax Number

*Cell Phone

*Work Phone

*Home Phone

*Email

*Coverage Area

Please provide a brief description of the requested primary
coverage area by state and either county or city.

*Work Experience/Education

How long have you been a notary public?

How long have you been a signing agent?

How many loan signings have you done in the last year?

What types of loan signings have you done?

Can you provide references for signing work? Yes No

If yes, please provide:

*Name
*Phone
Name
Phone
Name
Phone

What industry designations have you acquired?

Please describe your industry-related work experience.

What is your availability for signings?

What is your average signing fee?

*Technological Capabilities

Do you have the capability to receive e-docs? Yes No

Which types of hardware do you have access to?

High Quality PrinterScanner
Fax MachineLegal size
Letter size

Which types of hardware do you have access to?

Which types of software do you have access to?

High Speed InternetEmail
Adobe AcrobatSwiftview
Word Processing

Have you ever been convicted of a felony, misdemeanor or any public offense having as one of its elements a fraudulent or dishonest act?

Yes No

The foregoing application has been completed by me to induce ISGN to approve me as a ISGN Affiliate. I hereby certify that the answers and statements made are true and correct to the best of my knowledge and belief. In connection with my application, I understand that my references will be contacted.