Professional Corporation

Contact Information

Name

First Last

Email*

Enter Email Confirm Email

Phone*

The name of the professional corporation is

Principal Office Address

Street Address Address Line 2 City State ZIP Code

Is the mailing address different?

Yes
No

Principal Mailing Address

Street Address Address Line 2 City State ZIP Code

Business Phone

Business Email

Courtesy Annual Report

Please check if you would prefer to receive the courtesy Annual Report Reminder by email.

The number of shares the professional corporation is authorized to issue:

Share Type (optional)	No. of Authorized Shares	Par Value (optional)	Comments (optional)

The name of the professional corporation's initial registered agent is:

First Last

The complete address of its initial registered office (agent's business address) is:

Street Address Address Line 2 City State ZIP Code

Describe the professional service(s) as defined in RSA 294-A, including necessary related services, for which the professional corporation is organized (and if known, list the NAICS Code and Sub Code) [if more space is needed, attach additional sheet(s)]:

(A benefit corporation shall have a purpose of creating general public benefit per RSA 293-C:6)

The named business is electing, by at least the minimum status vote defined by RSA 293-C:2, VII to become a benefit corporation pursuant to RSA 293-C

Yes
No

Fiscal year end date of the benefit corporation

OFFICER / DIRECTOR INFORMATION

Name	Business Address	Title

List the name of each incorporator and their business address:

Name	Address

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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