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Part
A - Do Not Leave Any of the Spaces Blank
Your Name
Mailing
Address
City,
State, Zip
Telephone
No.
Fax No.
email
Date
of Birth
Social Security No.
Title
Dated:
***** Skip this section if you have a Social Security Number:
Part
B
- Do Not Leave Any of the Spaces Blank
Passport
No.
Place Issued
Expiration
Date
Date of Birth
Part C
- Do Not Leave Any of the Spaces Blank
Name
of Company
Corporate Address of
Company
For Corporation
Please check one. Will the Corporation file taxes as a
"C" Corporation - file 1120 or an
"S" Corporation - file 1120S
For
Limited Liability Company
Please check one. Is this a
Single Member LLC or an
Multi Member LLC? (If only single member you cannot file as a
partnership.
Please check one. Would the LLC like to be taxed as a
As a Corporation
As a Partnership?
Principal
business activity
To whom are products or services mostly sold
Public
Wholesale
Private Sector Other
Month Fiscal Year Ends
No. of Employees (if any)
I have read the disclaimer.
Disclaimer:
You are responsible for making sure that all documents submitted
for the purpose of setting up a new corporation or limited liability company
, bank account etc., are suitable for such purpose and otherwise
legally sufficient. This includes, without limitation, ensuring that
the documents are properly dated, executed, and certified where
appropriate.
Global Corporate Services, Inc. reserves the right to retain any moneys it receives
if there is positive evidence of fraud or any other material civil or criminal infractions by the applicant. Intentional falsifying
or withholding of information may subject the applicant to prosecution under the laws of the
State of Delaware and United States. In select cases, Global Corporate Services, Inc. may be obligated to share
information with
appropriate state and federal authorities. I
have not received personal counsel
or tax advice from Global Corporate Services, Inc.
Select Type of Payment
Credit Card
PayPal
Check or Money Order
Western Union
Corporate
Office and Address for the Corporation or LLC
One
Commerce Center
1201 N. Orange Street Suite 723
Wilmington, DE 19801 |
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