Business Company Registration Application

BUSINESS COMPANY REGISTRATION APPLICATION

Applicant Name:    Doing Business As:

RECITALS

WHEREAS, Applicant seeks to register and organize a business entity to lawfully transact business and to obtain official registration and related services from Registrar pursuant to the terms set forth in this Application; and

WHEREAS, Registrar provides formation, filing, and administrative registration services and requires the information, certifications, and fees set forth in this Application to process and maintain the registration of the business; and

WHEREAS, Applicant represents that the information provided in this Application is true, complete, and accurate and authorizes Registrar to prepare and file all documents necessary to effect registration in the jurisdiction indicated below.

APPLICATION INFORMATION

Corporation Limited Liability Company (LLC) Partnership Individual / Sole Proprietor

SCOPE OF WORK

The Registrar will perform the following services on behalf of Applicant as part of the registration and formation process. Applicant authorizes Registrar to take the actions described below in reliance on the representations contained in this Application.

PAYMENT TERMS

Registration Fee Amount:    Payment Schedule:

Late Fee or Interest for Overdue Amounts:

Payment Method (select applicable):   Credit Card Check Wire Transfer

TERM AND TERMINATION

Term Commencement Date:    Term Expiration Date:

Either party may terminate services for cause if the other party materially breaches any obligation and fails to cure within days after written notice. Registrar may suspend services for nonpayment following written notice of past due amounts.

CONFIDENTIALITY

Applicant and Registrar acknowledge that during the course of performance each may receive Confidential Information of the other. For purposes of this Application, "Confidential Information" means non-public business, financial, technical, and legal information disclosed in any form. Each party agrees to: (a) hold Confidential Information in strict confidence; (b) restrict disclosure to those employees, agents, and subcontractors who need access to perform obligations and who are bound by confidentiality obligations at least as protective as this clause; and (c) use Confidential Information solely to perform obligations under this Application. Confidential Information does not include information that is or becomes publicly known through no breach by the receiving party, is independently developed without use of Confidential Information, or is required to be disclosed by law or valid legal process, provided the disclosing party is given prompt notice to seek protective measures.

GOVERNING LAW

This Application, and any dispute arising out of or related to it, shall be governed by and construed in accordance with the laws of the state of without regard to its conflicts of law principles.

ENTIRE AGREEMENT

This Application constitutes the entire agreement between Applicant and Registrar with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, proposals, and communications, whether oral or written. Any amendment or modification must be in writing and signed by authorized representatives of both parties.

REPRESENTATIONS AND CERTIFICATIONS

By submitting this Application, Applicant certifies that the information provided is true, complete, and correct to the best of Applicant's knowledge. Applicant authorizes Registrar to file necessary formation and registration documents and to take incidental actions reasonably necessary to effect the registration and maintenance of the entity.

Applicant acknowledges that fees paid are non-refundable once filings are submitted, except as otherwise required by applicable law or by separate written agreement.

ADDITIONAL INFORMATION / INSTRUCTIONS

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