Nonprofit Corporation

Contact Information

Name

First Last

Email*

Enter Email Confirm Email

Phone*

Do you have a business reservation number?

Yes
No

Requested Business Name

Please provide 3 choices for the name, in order of preference, so in the event your preferred choice is not available we can proceed with your next choice. The name of the business must contain one of the following designations: Corporation, Corp., Corp, Incorporated, Inc., Inc, Company, Co., Co, Limited, Ltd., Ltd.

1st Choice*

2nd Choice

3rd Choice

Business Purpose

NAICS Code

NAICS Sub-Code

Principal Office Address

Address

Street Address Address Line 2 City State ZIP Code

Primary Email Address

Secondary Email Address

Do you have a Business Name Reservation Number

Yes
No

Registered agent is a:

Individual
Business

Registered Agent Name

First Middle Last

Business Name

Address

Street Address Address Line 2 City State ZIP Code

Incorporator Information

Organizer Type	Actions

There are no Organizers.

Optional Provisions

Signer is:

Incorporator
Attorney

Filer's Certification Signature*

By checking this box and continuing, each signatory certifies that the information provided herein is true, accurate, and complete to the best of his/her knowledge and belief, and that he/she has authorized the affixing of his/her electronic signature in accordance with the Electronic Signatures in Global and National Commerce Act (e-Sign) and O.C.G.A. § 10-12-1 et seq. Further, each signatory understands that his/her electronic signature has full legal effect and enforceability and he/she intends this form, as signed, to be filed with the office of the Georgia Secretary of State.

Application Fee

Price:

Please select an additional service that you wish to have processed

Priority Request / Rush Processing + $75

Total

$0.00

NAME:*

Type your full name to sign this secure webform

Signature*

CAPACITY OF PERSON SIGNING (E.G., AGENT, TRUSTEE, GENERAL PARTNER, CORPORATE OFFICER, MEMBER)

Authorization*

I agree

I agree to pay the above total amount according to the card issuer agreement and hereby authorize the charge for the total amount above for the processing of selected applications. I understand that my application will be processed in the order in which it is received by Corporation Center, a private fee-for-service company, not owned or operated by any governmental agency. I understand that application and processing fees are non-refundable as per Corporation Center’s no refund policy.

Credit Card

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