Nonprofit Corporation

Contact Information

Name

First Last

Email*

Enter Email Confirm Email

Phone*

(1) Do you already have a UBI No.? (Check one)

Yes
No

If Yes, provide UBI No.

Business Name

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.

1st Choice

2nd Choice

3rd Choice

Does the business have a name reserved? (Check one)

Yes
No

Reservation Number:

Reserved Name:

Fill

PURPOSE OF CORPORATION:	ANY OTHER PROVISIONS:

PERIOD OF DURATION:

This Corporation shall have a perpetual duration (default)
This Corporation shall have a duration of
This Corporation shall expire on

Durations

Expiration

EFFECTIVE DATE: Check ONE of the following:

Date of filing
Specify a date

Date

Is the Registered Agent a Commercial Registered Agent? (Check one)

Yes
No

If Yes, provide the name of the Commercial Registered Agent:

NON-COMMERCIAL REGISTERED AGENT Please complete ONE type of Registered Agent below and provide the name in the selected box. Then continue to provide the required street address. Mailing address is optional.

Individual
Business
Office of Position

Individual

Business

Office or Position

Phone

Email

Registered Agent Street Address (required) (Must be a physical address; No PO Box or PMB)

Street Address City State ZIP Code

Registered Agent Mailing Address (optional)

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

INITIAL BOARD OF DIRECTORS: Name and address of each initial director is required

Name	Address	City	State	Zip

DISTRIBUTION OF ASSETS:

In the event of voluntary dissolution, the net assets will be distributed as follows:

RETURN ADDRESS FOR THIS FILING: (Optional)

Attention:

Email

Address

Street Address City State ZIP Code

INCORPORATOR INFORMATION:

Name, address, and signature required. Attach additional sheets if necessary. I hereby certify, under penalty of law, that the above information is accurate and complies with the filing requirements of state law.

Name:

Address

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

Printed Name/Title

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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