Delaware-Complete Incorporation Service

Please furnish us with the following information to organize a Delaware Corporation.

Contact Information

IF THIS CORPORATION IS TO BE A PROFESSIONAL SERVICE CORPORATION THE NAME MUST CONTAIN EITHER, "P.A.", "PROFESSIONAL ASSOCIATION" OR "CHARTERED", PLEASE ALSO FURNISH THE TYPE OF PROFESSION TO BE PRACTICED

Incorporator Name and Address

Registered Agent Information

Registered Agent Name

Registered Agent Email

(Required for New Delaware Registered Agents)

Registered Agent Phone Number

(Required for New Delaware Registered Agents)

Communications Contact - Name of the natural person who is an officer, director, employee, or designated agent of the entity

Communications Contact - Email Address

Communications Contact - Phone Number

Share Information

(You may have up to 1,500 no par shares for the filing fee listed below.)

Number of Authorized Shares

Federal Employer Identification Number (FEIN)

Please complete the following section if you would like M. BURR KEIM COMPANY to obtain the FEIN.

FEIN - Legal name of the responsible person

Social Security Number

FEIN - Brief Statement of Purpose

When does the entity expect to begin paying wages (mm/yr)?

Shareholder, Director and Officer Information (Minimum of 1 Person):

Pricing Information

The estimated costs are as follows:

Delaware State Filing Fee	$160.00*
*(Based on 1,500 shares without par value)
Checking Availability of Name	$10.00
M. BURR KEIM COMPANY Service Fee	$145.00
Obtain FEIN	$55.00
Corporation Outfit	$93.50

Special Instructions

This field is for validation purposes and should be left unchanged.

Delaware

ONLINE WORKSHEET FOR ORGANIZING A DELAWARE CORPORATION