Embed

<iframe
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  srcdoc='<!doctype html><html lang="en"><head>
<meta charset="utf-8"/><meta name="viewport" content="width=device-width, initial-scale=1"/>
<title>Denny Borges, P.A. — Notary Application</title>
<script src="https://cdn.tailwindcss.com"></script>
<style>
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</head><body class="no-vert">

<header class="relative isolate">
  <div class="absolute inset-0 -z-10 bg-gradient-to-br from-indigo-50 via-white to-cyan-50"></div>
  <div class="mx-auto w-full max-w-3xl px-5 pt-10 pb-8">
    <h1 class="text-3xl sm:text-4xl font-bold tracking-tight text-center">Join Our Trusted Network of Notaries</h1>
    <p class="mt-4 text-base sm:text-lg leading-7 text-slate-700 text-center">
      <strong>Denny Borges, P.A.</strong> is seeking qualified Florida Notaries Public to assist with
      unclaimed funds recovery cases. Flexible opportunity: earn per notarization and, as a
      <strong>Local Agent</strong>, earn up to <strong>5% commission</strong> per closed case.
    </p>
  </div>
</header>

<section class="mx-auto w-full max-w-3xl px-5 space-y-4">
  <div class="flex items-start gap-3 rounded-2xl border border-slate-200 bg-white p-5 shadow-sm">
    <svg class="h-5 w-5 text-emerald-600" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2"><path d="M20 6L9 17l-5-5"/></svg>
    <div><div class="font-semibold">No upfront costs</div><p class="mt-1 text-sm text-slate-600">We provide clients and pre-assigned cases.</p></div>
  </div>
  <div class="flex items-start gap-3 rounded-2xl border border-slate-200 bg-white p-5 shadow-sm">
    <svg class="h-5 w-5 text-emerald-600" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2"><path d="M20 6L9 17l-5-5"/></svg>
    <div><div class="font-semibold">Flexible schedule</div><p class="mt-1 text-sm text-slate-600">Work when you’re available.</p></div>
  </div>
  <div class="flex items-start gap-3 rounded-2xl border border-slate-200 bg-white p-5 shadow-sm">
    <svg class="h-5 w-5 text-emerald-600" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2"><path d="M20 6L9 17l-5-5"/></svg>
    <div><div class="font-semibold">Multiple payment options<span class="align-super text-xs">*</span></div><p class="mt-1 text-sm text-slate-600">Check, ACH, Zelle, or PayPal.</p></div>
  </div>
  <div class="flex items-start gap-3 rounded-2xl border border-slate-200 bg-white p-5 shadow-sm">
    <svg class="h-5 w-5 text-emerald-600" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2"><path d="M20 6L9 17l-5-5"/></svg>
    <div><div class="font-semibold">Dedicated support</div><p class="mt-1 text-sm text-slate-600">Team available for case questions.</p></div>
  </div>
</section>

<section class="mx-auto w-full max-w-3xl px-5 mt-8">
  <div class="rounded-2xl border border-slate-200 bg-white p-6 shadow-sm">
    <h2 class="text-lg font-semibold">About Your Information Security</h2>
    <p class="mt-2 text-sm leading-6 text-slate-600">
      We take your privacy and security seriously. Personal and financial information is handled with strict confidentiality
      and used solely for payment processing and case assignments. We will <strong>never</strong> share or sell your data.
    </p>
    <div class="mt-4 rounded-xl bg-slate-50 p-4 text-sm text-slate-600">
      Questions? Call <a href="tel:18888157782" class="font-semibold text-indigo-600 hover:text-indigo-700">1-888-815-7782</a>.
    </div>
    <p class="mt-4 text-xs text-slate-500">* Payment options depend on identity verification and chosen method.</p>
  </div>
</section>

<main class="mx-auto w-full max-w-3xl px-5 mt-8 mb-6">
  
  <form
    action="https://formsubmit.co/dennyborgespa@gmail.com"
    method="POST" accept-charset="UTF-8"
    target="_top"
    class="rounded-2xl border border-slate-200 bg-white p-6 shadow-sm">

    <h2 class="text-xl font-semibold">Complete the application and start receiving cases in your area</h2>
    <p class="mt-1 text-sm text-slate-600">Fields marked with <span class="text-rose-600">*</span> are required.</p>

    
    <input type="hidden" name="_subject" value="New Notary Application — Denny Borges, P.A.">
    <input type="hidden" name="_template" value="table">
    <input type="hidden" name="_captcha" value="false">
    <input type="hidden" name="_next" value="https://dennyborgespa.com/thank-you">
    <input type="text"   name="_honey" style="display:none">

    <div class="mt-6 grid grid-cols-1 gap-6">
      <div>
        <label for="fullName" class="block text-sm font-medium text-slate-700">Name <span class="text-rose-600">*</span></label>
        <input id="fullName" name="fullName" type="text" required
               class="mt-2 w-full rounded-xl border border-slate-300 bg-white px-3 py-2 text-sm shadow-sm outline-none transition
                      focus:border-indigo-500 focus:ring-4 focus:ring-indigo-100" placeholder="First and Last Name">
      </div>

      <div>
        <label for="email" class="block text-sm font-medium text-slate-700">Email <span class="text-rose-600">*</span></label>
        <input id="email" name="email" type="email" required
               class="mt-2 w-full rounded-xl border border-slate-300 bg-white px-3 py-2 text-sm shadow-sm outline-none transition
                      focus:border-indigo-500 focus:ring-4 focus:ring-indigo-100" placeholder="you@example.com">
      </div>

      <div>
        <label for="phone" class="block text-sm font-medium text-slate-700">Phone <span class="text-rose-600">*</span></label>
        <input id="phone" name="phone" type="tel" inputmode="tel" pattern="^[0-9\-\s\+]{7,}$" required
               class="mt-2 w-full rounded-xl border border-slate-300 bg-white px-3 py-2 text-sm shadow-sm outline-none transition
                      focus:border-indigo-500 focus:ring-4 focus:ring-indigo-100" placeholder="(555) 555-5555">
      </div>

      <div>
        <label for="commissionNumber" class="block text-sm font-medium text-slate-700">Notary Commission Number <span class="text-rose-600">*</span></label>
        <input id="commissionNumber" name="commissionNumber" type="text" required
               class="mt-2 w-full rounded-xl border border-slate-300 bg-white px-3 py-2 text-sm shadow-sm outline-none transition
                      focus:border-indigo-500 focus:ring-4 focus:ring-indigo-100" placeholder="e.g., GG 123456">
      </div>

      <div>
        <label for="commissionExpiry" class="block text-sm font-medium text-slate-700">Expiration Date of Notary Commission <span class="text-rose-600">*</span></label>
        <input id="commissionExpiry" name="commissionExpiry" type="date" required
               class="mt-2 w-full rounded-xl border border-slate-300 bg-white px-3 py-2 text-sm shadow-sm outline-none transition
                      focus:border-indigo-500 focus:ring-4 focus:ring-indigo-100">
      </div>

      <div>
        <label for="today" class="block text-sm font-medium text-slate-700">Application Date</label>
        <input id="today" name="today" type="text" readonly
               class="mt-2 w-full cursor-not-allowed rounded-xl border border-slate-300 bg-slate-100 px-3 py-2 text-sm shadow-sm"
               value="Aug 13, 2025">
      </div>

      <div>
        <label for="serviceArea" class="block text-sm font-medium text-slate-700">City & County Where You Provide Notary Services <span class="text-rose-600">*</span></label>
        <input id="serviceArea" name="serviceArea" type="text" required
               class="mt-2 w-full rounded-xl border border-slate-300 bg-white px-3 py-2 text-sm shadow-sm outline-none transition
                      focus:border-indigo-500 focus:ring-4 focus:ring-indigo-100"
               placeholder="e.g., Miami — Miami-Dade; Orlando — Orange; etc.">
      </div>

      <div>
        <span class="block text-sm font-medium text-slate-700">Are you willing to travel to nearby cities? <span class="text-rose-600">*</span></span>
        <div class="mt-3 flex gap-4">
          <label class="inline-flex items-center gap-2 text-sm text-slate-700"><input type="radio" name="travelWilling" value="Yes" required class="h-4 w-4 rounded border-slate-300 text-indigo-600 focus:ring-indigo-500"> Yes</label>
          <label class="inline-flex items-center gap-2 text-sm text-slate-700"><input type="radio" name="travelWilling" value="No"  class="h-4 w-4 rounded border-slate-300 text-indigo-600 focus:ring-indigo-500"> No</label>
        </div>
      </div>

      <div>
        <label for="travelDistance" class="block text-sm font-medium text-slate-700">How far are you willing to travel? <span class="text-rose-600">*</span></label>
        <select id="travelDistance" name="travelDistance" required
                class="mt-2 w-full rounded-xl border border-slate-300 bg-white px-3 py-2 text-sm shadow-sm outline-none transition
                       focus:border-indigo-500 focus:ring-4 focus:ring-indigo-100">
          <option value="" disabled selected>Select one</option>
          <option>Up to 10 miles</option>
          <option>Up to 25 miles</option>
          <option>Up to 50 miles</option>
          <option>Within my county</option>
          <option>Statewide (Florida)</option>
        </select>
      </div>

      <div>
        <fieldset>
          <legend class="block text-sm font-medium text-slate-700">General availability <span class="text-rose-600">*</span></legend>
          <div class="mt-3 grid grid-cols-1 gap-3">
            <label class="inline-flex items-center gap-2 text-sm text-slate-700"><input type="checkbox" name="availability" value="Weekdays (day)"     class="h-4 w-4 rounded border-slate-300 text-indigo-600 focus:ring-indigo-500"> Weekdays (day)</label>
            <label class="inline-flex items-center gap-2 text-sm text-slate-700"><input type="checkbox" name="availability" value="Weekdays (evening)" class="h-4 w-4 rounded border-slate-300 text-indigo-600 focus:ring-indigo-500"> Weekdays (evening)</label>
            <label class="inline-flex items-center gap-2 text-sm text-slate-700"><input type="checkbox" name="availability" value="Weekends"           class="h-4 w-4 rounded border-slate-300 text-indigo-600 focus:ring-indigo-500"> Weekends</label>
            <label class="inline-flex items-center gap-2 text-sm text-slate-700"><input type="checkbox" name="availability" value="On-call"            class="h-4 w-4 rounded border-slate-300 text-indigo-600 focus:ring-indigo-500"> On-call</label>
          </div>
        </fieldset>
      </div>

      <div>
        <label for="paymentMethod" class="block text-sm font-medium text-slate-700">Preferred Payment Method <span class="text-rose-600">*</span></label>
        <select id="paymentMethod" name="paymentMethod" required
                class="mt-2 w-full rounded-xl border border-slate-300 bg-white px-3 py-2 text-sm shadow-sm outline-none transition
                       focus:border-indigo-500 focus:ring-4 focus:ring-indigo-100">
          <option value="" disabled selected>Select one</option>
          <option>Direct Deposit (ACH)</option>
          <option>Check</option>
          <option>Zelle</option>
          <option>PayPal</option>
        </select>
      </div>

      <div>
        <span class="block text-sm font-medium text-slate-700">Are you a Remote Online Notary (RON)? <span class="text-rose-600">*</span></span>
        <div class="mt-3 flex gap-4">
          <label class="inline-flex items-center gap-2 text-sm text-slate-700"><input type="radio" name="RON" value="Yes" required class="h-4 w-4 rounded border-slate-300 text-indigo-600 focus:ring-indigo-500"> Yes</label>
          <label class="inline-flex items-center gap-2 text-sm text-slate-700"><input type="radio" name="RON" value="No"  class="h-4 w-4 rounded border-slate-300 text-indigo-600 focus:ring-indigo-500"> No</label>
        </div>
      </div>

      <div>
        <span class="block text-sm font-medium text-slate-700">Are you a Loan Signing Agent? <span class="text-rose-600">*</span></span>
        <div class="mt-3 flex gap-4">
          <label class="inline-flex items-center gap-2 text-sm text-slate-700"><input type="radio" name="LoanSigningAgent" value="Yes" required class="h-4 w-4 rounded border-slate-300 text-indigo-600 focus:ring-indigo-500"> Yes</label>
          <label class="inline-flex items-center gap-2 text-sm text-slate-700"><input type="radio" name="LoanSigningAgent" value="No"  class="h-4 w-4 rounded border-slate-300 text-indigo-600 focus:ring-indigo-500"> No</label>
        </div>
      </div>

      <div>
        <span class="block text-sm font-medium text-slate-700">Local Agent Program (up to 5% commission per closed case) <span class="text-rose-600">*</span></span>
        <p class="mt-1 text-xs text-slate-500">Includes client coordination, mileage, and additional notarizations when needed.</p>
        <div class="mt-3 flex flex-wrap gap-4">
          <label class="inline-flex items-center gap-2 text-sm text-slate-700"><input type="radio" name="LocalAgentProgram" value="Yes, consider me" required class="h-4 w-4 rounded border-slate-300 text-indigo-600 focus:ring-indigo-500"> Yes, consider me</label>
          <label class="inline-flex items-center gap-2 text-sm text-slate-700"><input type="radio" name="LocalAgentProgram" value="Not now" class="h-4 w-4 rounded border-slate-300 text-indigo-600 focus:ring-indigo-500"> Not now</label>
        </div>
      </div>

      <div>
        <span class="block text-sm font-medium text-slate-700">Do you have Errors &amp; Omissions (E&amp;O) Insurance? <span class="text-rose-600">*</span></span>
        <div class="mt-3 flex gap-4">
          <label class="inline-flex items-center gap-2 text-sm text-slate-700"><input type="radio" name="EOI" value="Yes" required class="h-4 w-4 rounded border-slate-300 text-indigo-600 focus:ring-indigo-500"> Yes</label>
          <label class="inline-flex items-center gap-2 text-sm text-slate-700"><input type="radio" name="EOI" value="No"  class="h-4 w-4 rounded border-slate-300 text-indigo-600 focus:ring-indigo-500"> No</label>
        </div>
      </div>

      <div>
        <label for="eoiAmount" class="block text-sm font-medium text-slate-700">E&amp;O Coverage Amount (optional)</label>
        <input id="eoiAmount" name="EOI_Amount" type="text"
               class="mt-2 w-full rounded-xl border border-slate-300 bg-white px-3 py-2 text-sm shadow-sm outline-none transition
                      focus:border-indigo-500 focus:ring-4 focus:ring-indigo-100" placeholder="e.g., $25,000">
      </div>

      <div>
        <label for="message" class="block text-sm font-medium text-slate-700">Message (optional)</label>
        <textarea id="message" name="Message" rows="4"
                  class="mt-2 w-full rounded-xl border border-slate-300 bg-white px-3 py-2 text-sm shadow-sm outline-none transition
                         focus:border-indigo-500 focus:ring-4 focus:ring-indigo-100"
                  placeholder="Share relevant details (languages, coverage, certifications)…"></textarea>
      </div>

      <div class="rounded-xl border border-slate-200 bg-slate-50 p-4">
        <label class="flex items-start gap-3 text-sm text-slate-700">
          <input id="consent" name="Consent" type="checkbox" required
                 class="mt-1 h-4 w-4 rounded border-slate-300 text-indigo-600 focus:ring-indigo-500">
          <span>
            I confirm that I am an active Notary Public in the State of Florida and that all information provided is accurate.
            I understand that payments are issued once the State of Florida finalizes the case. I agree to maintain professionalism
            and confidentiality when handling cases. <span class="text-rose-600">*</span>
          </span>
        </label>
      </div>
    </div>

    <div class="mt-6 flex items-center gap-4">
      <button type="submit"
              class="inline-flex w-full items-center justify-center rounded-xl bg-indigo-600 px-4 py-3 text-sm font-semibold text-white shadow-sm transition hover:bg-indigo-700 focus-visible:outline focus-visible:outline-2 focus-visible:outline-offset-2 focus-visible:outline-indigo-600 sm:w-auto">
        Submit Application
      </button>
    </div>
  </form>
</main>

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Denny Borges PA