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Form A Business - Professional Practice (PC) - Order Form


Welcome to the Diversified Corporate Services PC Incorporations order form.  

Contact Information ( * denotes mandatory)

Full Name * :
E-mail * :
Street Address:
City:
State:
Zip:
Home Phone:
Work Phone:

General Information

State of Formation * :
Entity Name * :
(Please list two options to ensure availability)
List names exactly as they should appear, including name ending (i.e. P.C., PC)

Agent Information (Not neccessary for NY State)

Registered Agent Name * :
Street Address * :
I have no agent. Please provide a registered agent for this entity. ($175)

Entity Information

Mailing Address * :
County * :

Shares

Number of Shares: Usually 200, NPV, Common
Par Value: $
NOTE: If Unspecified, entity will be formed with standard amount of shares.

Director Information

Director Name:
Director Address:
Number of additional Directors:
NOTE: you will be asked for more information regarding the additional individuals (if any) when our representative contacts you to process your order.

Corporate Supplies (Optional)

Kit & Seal
Seal

EIN Information (Optional)

Please provide a Tax ID number for this entity ($75)
Name of President:
Social Security Number:
Principal Business Activity:
Business Type: C-Corporation
S-Corporation

S-Corp (Optional)

Shareholder Name:
Social Security #:
Shareholder Address:
Percentage of shares: %
Number of additional members:
NOTE: you will be asked for more information regarding the additional shareholders (if any) when our representative contacts you to process your order.

Payment / Billing

NOTE: You will be contacted by Diversified Corporate Networks regarding payment and processing of this form.

Special Instructions

Please provide any special instructions.

Questions About This Entity Formation


*


*

To speak with a live representative about this order please call 518-434-2877

 

Please Enter The Verification Code.
Verification Code

 

Carefully review your order before clicking submit.
Deluxe Entity Formation Packages
Deluxe Packages include 24 hr. formation, personalized binder & slipcase, Minutes & By-Laws or Operating Agreement, chrome plated seal, and stock certificates, ready for delivery 24 hrs. after filing, plus shipping.
  Inc. LLC       
New York $274 $395***  
New Jersey $295 $320      
Delaware $305 $305      
Florida $250 $285      
Nevada $490 $495      
California $480 $335      
Pennsylvania $360 $360***  
View All State Prices
 
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