Limited Liability Corporation

Contact Information

Name

First Last

Return to address

Street Address Address Line 2 City State ZIP Code

Email*

Enter Email Confirm Email

Phone*

The name of the professional limited liability company is:

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 shall contain the words "Professional Limited Liability Company" or the abbreviation "P.L.L.C.", "P.L.C.", "PLLC" or "PLC".

Name choice (2)

Name choice (3)

The limited liability company is organized for the sole and specific purpose of rendering the following professional service(s):

The duration of the limited liability company if other than perpetual is:

The name of the resident agent is:

First Last

The address of the registered office is:

Street Address Address Line 2 City State ZIP Code

Address has to be a physical address not a PO Box.

Is the mailing address different?

Yes
No

The mailing address of the registered office, if different than above:

Street Address Address Line 2 City State ZIP Code

Any additional provisions authorized by the act

Preparer's Name

First Last

Business telephone number

Application Fee

Price:

Please select an additional service that you wish to have processed

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.

Credit Card

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