1. CORPORATE NAME – Enter the full name of the corporation in the space provided:

(Instructions: The name of the corporation must end with “Incorporated” or “Corporation”, or may be abbreviated “Inc.” or “Corp.”)

2. CORPORATE ADDRESS – Enter the street address of the principal office of the corporation and the mailing address of the corporation (if different):

3. PURPOSE OF CORPORATION

Important Note: Please briefly describe what the corporation will do. A general statement of “any and all lawful business” will not be sufficient.)

4. INITIAL DIRECTORS – Enter the names and addresses of the individual who is to serve as the initial director of the corporation (optional):

(Note: This is optional. If you respond, please list at least three (3) directors).

5. INITIAL OFFICERS – Enter the names and addresses of the individuals who are to serve as the initial officers of the corporation (optional):

6. REGISTERED AGENT

(Note: A P.O. Box is NOT acceptable. The registered agent is the individual who will serve as the agent of the corporation for the purpose of being served with legal papers).

7. INCORPORATOR

8. SPECIAL REQUEST/INSTRUCTIONS:

9. METHOD OF DELIVERY. How would you like the documents delivered to you? (choose one option)

10. EIN. Do you want us to provide you with an EIN? (choose one (1) option):

11. FOR NON PROFIT CHARITIES ONLY: If your non profit corporation will be organized and operated for charitable, religious, educational or scientific purposes, then you may wish to apply for 501(c)(3) tax exempt status with the IRS. There will be an additional fee for this service. Please indicate whether you wish to receive our “Information Questionnaire” to begin the application process as a 501(c)(3) charity:

Customer authorizes Quikform Services to perform the services selected above. Customer understands and agrees that Quikform Services is a document filing service and has not provided any legal advice to Customer.