PLEASE PRINT, COMPLETE AND FAX THIS FORM TO (703) 995-0899)

Click here for information the 501(c)(3) tax exempt status

Part I - CREDIT CARD AUTHORIZATION FORM - Billing Information

__________________________________  DOES HEREBY AUTHORIZE THOMPSON & THOMPSON PC
             (Name on Card) 
to charge the amount of $ 2995.00 to its: Mc.gif (1385 bytes)     Visa.gif (1131 bytes)     Amexlogo.gif (1787 bytes)

Account No. __________________________________    Expiration Date _____________

Name as it appears on card __________________________________________________

Credit Card Billing Address __________________________________________________
(if mail forwarding address is different, use separate sheet of paper)

City, State, Zip _____________________________________________________________

Telephone No. ________________________  Fax No. _____________________________

Email Address ___________________________________________

Signed By ____________________________________  Social Security # _______________________

Title __________________________     Dated ______________________

We also accept payment by PayPal. To pay by PayPal our email address is paypal@delawarecorp.us.

Part II - Information Required to complete the Application to the IRS for the 

501(c)(3) Tax Exemption - (Please do not leave any information blank).

Your Name ______________________________  Office/Position/Title ______________________

Company Name __________________________________________________

Company Address ________________________________________________

City, State, Zip ___________________________________________________

Telephone _______________________ Fax ___________________________

Email Address ____________________________________________________

Is your organization already incorporated? Yes   No - If no, for Delaware only see

http://global-inter.net/nonprofit.htm. For all other states please call toll free 800-219-9359.

State of Incorporation ______________________ Year Incorporated ______________

Employer ID Number (EIN) __________________________________

Has your organization previously applied for tax exemption? Yes   No

What are your organization's exempt purposes? Check all that apply:

Charitable Educational Religious  Scientific Literary Testing for Public Safety

To foster national/international amateur sports competition 

When did your organization begin its operations? ____________________

Describe Your Organization's Activities: ________________________________________

____________________________________________________________________________

What do you estimate your organization's Annual/Projected Revenues: ____________

Describe your organization's present & planned revenue sources: _________________

_____________________________________________________________________________

Is your request urgent? Yes   No  (note: it usually takes from three to six months to get IRS

approval. If yes, please describe the urgency.____________________________________

 _____________________________________________________________________________

______________________________________________________________________________

Thank you for your prompt attention to this invoice. Global Corporate Services, Inc. does not provide personal counsel or tax advice. The application and credit card will be processed by our attorneys, the firm of THOMPSON & THOMPSON PC.


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