Corporation Order Form

Personal Contact Information:
Name *
Name
Address *
Address
Cell Phone
Cell Phone
Fax
Fax
Name of my corporation:
Must include one of these suffixes: Inc., Incorporated, Corp., or Corporation
Fictitious Business Name(s) (FBN) or Doing Business As (DBA):
I name the following person(s) as the Incorporator(s) of the corporation:
Name of Incorporator 1 (One)
Name of Incorporator 1 (One)
Name of Incorporator 2 (Two)
Name of Incorporator 2 (Two)
LOCAL business address of my corporation:
Local Address *
Local Address
Initial Agent for Service of Process:
Name
Name
Address
Address
I name the following person(s) as Corporate Officers, Directors and Shareholders of the corporation:
Note: This could be all one person for every position / title
Name of President (Chief Executive Officer) *
Name of President (Chief Executive Officer)
Name of Vice President (Optional)
Name of Vice President (Optional)
Name of Treasurer (Chief Financial Officer) *
Name of Treasurer (Chief Financial Officer)
Name of Secretary *
Name of Secretary
Name of Director 1 (One) *
Name of Director 1 (One)
Name of Director 2 (Two)
Name of Director 2 (Two)
Name of Director 3 (Three)
Name of Director 3 (Three)
Name of Director 4 (Four)
Name of Director 4 (Four)
Stock Owners
Provide name of person(s) to own stock and the percentage (%) of stock owned