Corporation/LLC Order Form Contact Person’s Name: Email: Phone: Type of Business Entity: Corporation S-Corporation LLC Proposed Business Names: (Please give 3 choices) 1. 2. 3. Business Address: City, State, Zip Code: County: In what state would you like to form your new business? AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming--District of ColumbiaPuerto RicoGuamAmerican SamoaU.S. Virgin IslandsNorthern Mariana Islands Principal Business Activity/Industry: Principal Officer Information: Name: Address: City, State, Zip Code: Social Security Number: Payment: $695 I understand that I am paying $695 for the formation of my new business.