Profit Corporation - Corp Center

Contact Information

Name

First Last

Email*

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Phone*

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,” “limited” or an abbreviation of one of these terms.

1st Choice

2nd Choice

3rd Choice

2. Purpose:

4. Who/What is the name of the Registered Agent (Individual or Business Entity or Commercial Registered Agent)?:

The address must be listed if you have a non-commercial registered agent. See instructions for further details. Address of the Registered Agent:

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

4. Name, Signature and Address of Incorporator (attach additional page if there is more than 1 incorporator)

Name of Incorporator

Address of Incorporator

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

6. Principal Address:

Street Address City State ZIP Code

Type 1

Type 1 number of shares

Type 2

Number of Shares

Please list the officers and directors of the corporation. Must have at least 1 officer and 1 director within the 1st year of the corporation.

Name	Position	Street	City	State	Zip

Is this a female owned business?

Yes
No

Is this a minority owned business?

Yes
No

If yes, please specify:

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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