Request for Officiant

Use this Request for Wedding Officiant service only.

Otherwise please
Use Request for Basic Notary service form
or
Use Request for Florida Notary Class form

Provide basic information and submit this form.
A professional from JaxNotary.com will contact you soon.

Your information will not be shared or sold
and this is NOT a contract.

If you need service within the next 12 hours,
call now: (904) 298-5939.

Mark all that apply

Standard Wedding Package. $150	Wedding ceremony with your words and vows, meetings, certificates and much more.
Standard Wedding Package with Assistance, Attendance, Coordination at rehearsal: total $200	Wedding ceremony with your words and vows, meetings, certificates, with attendance, coordination and assistance at the rehearsal and much more.
$25 Mileage fee	Add $25 for service 26 to 49 Miles from Home office. (see note #1)
$50 Mileage Fee	Add $50 for service 50 to 74 Miles from Home office. (see note #1)
$10 After hours fee	Add $10 for ANY service between 9pm and 9am
Military Discount	Discount $10 if Military (Active, Reserve or Retired). MUST SHOW ID. Only one Military discount will apply.
Military, Combat Veteran, Discount.	Discount $20 if Military Combat Veteran (Active, Reserve or Retired). MUST SHOW ID & PROOF OF COMBAT. Only one Military discount will apply.
First Name:
Last Name:
Are you a Bride, Groom, Planner, or other?: *
Address of where service is needed: Street 1:
Address Street 2:
City:
Zip Code:	(5 digits)
Wedding Month:
Wedding Date:
Wedding Year:
Wedding Time (include AM or PM):
Rehearsal Month, Day, Year and Time:
If wedding date or rehearsal date is unknown please indicate here:
Are you having a rehearsal?:
Will the Officiant attend, coordinate and assist at the Rehearsal?:
Getting married? Please provide full name of other person.	(Groom or Bride or name of both if you are a planner)
Daytime Phone:
Evening Phone:
Email:
Comments:	Provide other details as needed.

Note 1: We use MapQuest.com, our home office address is 1038-5 Dunn Ave PMB 83, Jacksonville, Florida 32218