CONFIDENTIAL INFORMATION FORM  
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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:  

 Part B - Do Not Leave Any of the Spaces Blank

***** Skip this section if you have a Social Security Number:

Passport No. Place Issued    

Expiration Date Date of Birth

Part C - Do Not Leave Any of the Spaces Blank

Please check one: CORPORATION FOR PROFIT NON PROFIT CORPORATION LLC  Series LLC LIMITED PARTNERSHIP

Name of Company (choice one)
 
For CORP ending select INC., LTD. or CORP. For LLC select LLC, L.L.C., or Limited Liability Company
Name of Company (choice two)
 
For CORP ending select INC., LTD. or CORP. For LLC select LLC, L.L.C., or Limited Liability Company
For Corporation
 Please check one. Will the Corporation file taxes as a "C" Corporation - file 1120  or an  "S" Corporation - file 1120S

The number of authorized shares of common stock is 1,500 shares at no par value. 

If other, the authorized shares of stock is:

at par no par value. (there may be additional filing fees)

For Limited Liability Company
Please check one. Would the LLC  like to be taxed as a As a Corporation As a Partnership

Please check one. Is this a Single Member LLC or an Multi Member LLC? If multi member Number of Members (The IRS says that to be taxed as a partnership there must be two or more members)

If the LLC has only one member do you want to be taxed as a "C" Corp or an "S" Corp? 

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)  

Apostille @ $120.00 per country. List country

Please acknowledge. There are no cancellations and/or refunds once the corporation has been filed with the State of Delaware. Please sign and fax this form back to Global Corporate Services, Inc. at (703) 995-0899.

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.

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Corporate Office and Address for the Corporation or LLC
 704 N. King Street Suite 500
P. O. Box 1031
Wilmington, DE 19899
County of New Castle
 

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