Name *

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Last

Email *

I would like to form a Domestic Company:

Name of any current Domestic Company (ies):

(must end with the word "Limited")

Alternative Name(s):

(must end with the word "Limited")

Main Objective and purpose of the Company:

Memorandum and Articles of Association:

Provide Specific Instructions Below:

Authorized Share Capital:

Par Value of Shares:

Specific instructions as to value, class and rights of shares, if any:

Registered Office:

If other, please specify:

Directors/Secretary (Must have at least one)

Name *

First

Last

Occupation:

Amount OR Percent of Shares:

Please specify number of shares or percentage of shares above.

Shareholder/s (Not less than one nor more than twenty):

List name/address/occupation/% of shares of all other shareholders:

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First

Last

I have couried a check payable to Glenn D. Godfrey & Co. LLP to cover the services requested:

Provide check amount above.

OR

Signature of Beneficial Owner:

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