NRAI Services - Incorporation Worksheet form

160 Greentree Drive, Suite 101, Dover, DE 19904 | Phone: 302-674-4089 | Fax: 302-674-5266 | Email: @

Please provide your default contact information:

Name
Company/Firm
Address 1
Address 2

City

State

Zip

Work Phone		Fax
Email Address

Please provide the following information:

Project Matter/Reference Number

State:

Requested Name:

First Choice
Second Choice
Third Choice

Agent: (NRAI will appoint an agent if none provided)

Agent's Name
Street Address

Authorized Stock:

Class

No. Shares Authorized

Par Value

Specific Purpose (required in some states):

Initial Directors:

Name
Address
Name
Address
Name
Address

States in which the company will qualify:

Options:

Corporate Kit
consists of corporate seal, minute book, binder, 20 printed stock certificates, printed minutes and Bylaws, and sample resolutions. UPS ground shipment is included in price. Overnight shipping available for additional charge.

Certified Copy

Good Standing

Special Instructions :

To be filed by

Confirmation needed by

Ship via: (unless specific instructions are provided, your results will be sent to the default information above)

	Fax	#			Regular Mail
	FedEx	#			UPS	#

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