Profit Corporation - Corp Center

Contact Information

Name

First Last

Email*

Enter Email Confirm Email

Phone*

1. Corporation 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

2. Incorporated under the laws of:

3. Date of incorporation:

4. Period of duration:

5. Mailing address of the corporation:

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

6. Principal office address:

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

7. Name and physical address of its registered agent:

Name

Address

PO Box is acceptable if listed in addition to a physical address.

Street Address City State ZIP Code

8. Purpose or purposes of the corporation which it proposes to pursue in the transaction of business in Wyoming:

(How will the assets be distributed if the nonprofit corporation is dissolved?)

9. Names and usual business addresses of its current officers and directors:

President Name

President Address

Vice President Name

Vice President Address

Secretary Name

Secretary Address

Treasurer Name

Treasurer Address

Directors

Name	Address

3 Directors

10. Aggregate number of shares or other ownership units which it has the authority to issue. (Itemize by classes, par value of shares, shares without par value and series, if any, within a class.)

11. Aggregate number of issued shares or other ownership units.(Itemize by classes, par value of shares, shares without par value and series, if any, within a class.)

13. Certification. (Please check the box to complete the required certification.)

I consent on behalf of the business entity to accept electronic service of process at the required email address provided on the form under the circumstances specified in W.S. 17-28-104(e).

Printed Name

Title:

Contact Person:

Daytime Phone Number:

Email

Consent to Appointment by Registered Agent

(name of registered agent)

*(registered office physical address, city, state, & zip)

(name of business entity)

Print Name:

Title:

Daytime Phone:

Email

Registered Agent Mailing Address

(if different than above):

Application Fee

Price:

Please select an additional service that you wish to have processed

Priority Request / Rush Processing + $75

Total

$0.00

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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Agree to Terms and Conditions*

I agree to the terms and conditions below: