state llc forms by bestman

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									                                        PLEASE FILL & FAX THIS FORM TO 1 (305) 402-2248
                                                                                                             LLC ORDER FORM
                                                                                                                   Date:                 Code:
                                                                                                  Nbr:


                                                                                             Internal use




Select the Plan
Basic Plan - $89 + State Fees                                                                                             STATE
Full Plan - $299 + State Fees
Super Plan - $ 499 + State Fees

Optional Services (only for Basic Plans)
Business Licenses Compliance Package $ 99.-                                       Expedited Filing $ 99.-
Corporate Kit with embosser $ 79.-                                                S Corporation Form Preparation $ 39.-
One year of Registered Agent Services $ 149.-                                     Obtain FEIN $ 59.-

Company Information:
Preferred Name:
Alternative Name:

Corporate address:

Street                                                                                                        City:
State                                                                               Zip:                      Country:

Main Activity:

Registered Agent: (If leaved blank Active Filings, LLC will be your Registered Agent)
Name:
Street:                                                                                                       City:
County:                                                                       State:                          Zip:

Members Information:
Name:                                                                                                         SSN:
Street:                                                                                                       City:
State:                                                                              Zip:                      Country:

Name:                                                                                                         SSN:
Street:                                                                                                       City:
State:                                                                              Zip:                      Country:

Contact, Billing & Shipping Information
Name:
Street:                                                                                                       City:
State:                                                                              Zip:                      Country:
Phone #:                     (           )                                          Fax #:               (     )
Email:

Payment Information
Credit Card:                     Visa        MC       Amex      Discovery                          Number:
Exp:                                    (MMM/yy)        Verifier:
I hereby authorize the staff of Active Filings, LLC., to form a Limited Liability Company on my    X
behalf. I declare having read the terms of use of the service to be provided.                                                Signature

								
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