Professional Corporation

Contact Information

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BUSINESS CORPORATION
PROFESSIONAL CORPORATION

REGISTRY NUMBER:

1. 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.The name must contain the word "Corporation", "Company", "Incorporated", or "Limited" or an abbreviation of one of such words. For a PROFESSIONAL CORPORATION, the name must contain the words "Professional Corporation", or abbreviations thereof, i.e., "P.C.", or Prof. Corp.

Name choice (2)

Name choice (3)

2. PRINCIPAL OFFICE: (Must be a physical street address)

Street Address City State / Province / Region ZIP / Postal Code

3. REGISTERED AGENT: (Individual or entity that will accept legal service for this business)

4. REGISTERED AGENT'S PUBLICLY AVAILABLE ADDRESS: (Must be an Oregon Street Address, which is identical to the registered agent's office.)

Street Address City State / Province / Region ZIP / Postal Code

5. ADDRESS WHERE THE DIVISION MAY MAIL NOTICES:

Street Address City State / Province / Region ZIP / Postal Code

6. NUMBER OF SHARES: (At least one share must be listed.)

7. IF RENDERING A LICENSED PROFESSIONAL SERVICE OR SERVICES, DESCRIBE THE SERVICE(S) BEING RENDERED:

(PROFESSIONAL CORPORATION ONLY) ORS 58.015(5)(m)

8. OPTIONAL PROVISIONS:

BENEFIT COMPANY
INDEMNIFICATION

WHO IS FORMING THIS BUSINESS? (INCORPORATORS)

Name and Address

OWNERS: (MEMBERS) (Names and Addresses)

Name and Address

MANAGERS: (MANAGERS) (Names and Addresses)

Name and Address

INDIVIDUAL WITH DIRECT KNOWLEDGE (Name and Address)

Name and Address

List the name and address of at least one individual who is a member or manager of the LLC or an authorized representative with direct knowledge of the operations and business activities of the LLC.

EXECUTION/SIGNATURE OF EACH PERSON WHO IS FORMING THIS BUSINESS: (Organizer)

PRINTED NAME:	TITLE:

I declare as an authorized signer, under penalty of perjury, that this document does not fraudulently conceal, fraudulently obscure, fraudulently alter or otherwise misrepresent the identity of the person or any members, managers, employees or agents of the limited liability company. This filing has been examined by me and is, to the best of my knowledge and belief, true, correct, and complete. Making false statements in this document is against the law and may be penalized by fines, imprisonment or both.

CONTACT NAME: (To resolve questions with this filing)

PHONE NUMBER: (Include area code)

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.

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