Nonprofit Corporation

PARISH

Name of Corporation

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. Name of the corporation may contain the word “corporation”, “company”, “incorporated”, “limited” or an abbreviation of one of these words.

1st Choice

2nd Choice

3rd Choice

This company is formed for the purpose of: (check one)

Engaging in any lawful activity for which corporations may be formed under Chapter 2, Title 12, of the La. Revised Statutes (Non-Profit Corporation Law)
Other

Other

The duration of this corporation is: (may be perpetual)

The location and municipal address (not a P.O. Box only) of this corporation’s registered office

Street Address City State ZIP Code

The full name of this corporation’s registered agent(s) is/are:

Address

Street Address Address Line 2 City State ZIP Code

The full name of each incorporator of this corporation is:

Address

Street Address Address Line 2 City State ZIP Code

The corporation’s initial board of directors, municipal addresses (not a P.O. Box only) and term of office are:

Name	Address	Term of Office

Other Provisions

Contact Information

Name

First Last

Email*

Enter Email Confirm Email

Phone*

Application Fee

Price:

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Priority Request / Rush Processing + $75

Total

$0.00

Consent

I agree

I CERTIFY THAT THE RECITATIONS CONCERNING THE VESSEL: NAME, TONNAGE, DIMENSIONS, PROPULSION, OWNERSHIP, HAILING PORT, RESTRICTIONS, ENTITLEMENTS, REMARKS AND ENDORSEMENTS CONTAINED IN THE CERTIFICATE OF DOCUMENTATION REMAIN ABSOLUTELY THE SAME.

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.

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