Incorporate A Business Corporation Order Form

>> CORPORATION ORDER FORM

Call us Toll Free today at 1.845.398.0900 and one of our representatives will be happy to complete your order over the phone, and/ or answer any questions that may come up while you complete this form.

Select the State you want to Incorporate in:

Select a Service Package:

1. Customer Information:

Your Full Name:

Your E-Mail:

Your Phone Number:

Address Line 1:

City:

County:

State:

Zip Code:

2. General Company Information:

Company Name 1:

Company Name 2:

Company Name 3:

Company Address: Same as Mailing Address

Full Name:

Address Line 1:

City:

County:

State:

Zip Code:

Business Purpose:

Authorized Stock: Shares of Par Value at
dollars/share

Director 1 Information: Same as Mailing Address

Full Name:

Address Line 1:

City:

County:

State/Province:

Zip:

Director 2 Information:

Name:

Address Line 1:

City:

County:

State/Province:

Zip:

Director 3 Information:

Name:

Address Line 1:

City:

County:

State/Province:

Zip:

3. Registered Agent Services:

Incorporate A Business.com will serve as Registered Agent ($149.00/year) * 1st year included in Flagship Package
Individual Listed Below will serve as Registered Agent (One time $50 charge).

Registered Agent Name:

Address Line 1:

City:

County:

State:

Zip:

4. Optional Add-Ons: (Check all that apply)

Complete Walk in Expediting Service [$99.00]: Yes [ HELP ]

Corporate Kit [$69.00]: Yes

Partially Completed EIN [$25.00]: Yes

Partially Completed S-Corp Election Form [$25.00]: Yes

5. Order Summary:

Package Type:

Service Fee:

State Fee:

State Name:

Registered Agent Fee:

Optional Add-On Items:

Total Cost:

6. Billing Information:

Pay By:
Phone (Your order will be processed after we receive a valid Credit Card that is approved for the charges shown).

Credit Card (Your order will be processed after your credit card is approved for the charges shown).Please note that there is a $50 cancellation charge once your order is processed.
**International Customers: billing arrangements will be made by phone. Once the order is placed, we will contact you for Billing Information

Credit Card Type:

Credit Card Number:

Exp Date: /

Billing Address: Same as Mailing Address

Card Holder's Name:

Address Line 1:

City:

State:

Zip Code :

Phone Number:

Fax Number:

Security Code:

Clicking this button will submit your order. Please verify that your phone number and email address are correct before you proceed.