AcroForm
REQUEST-TO-FORM.pdf
E6131F0DBF323D428B0E3D4C69F924EC
Request To Form — PLEASE EMAIL IMAGE/PICTURE OF THIS PAGE TO FORMATIONS@EMPIRESTATELEGAL.COM — e one-time cost of the Fasst! Formation Package is $599 and no other costs will apply! Dear Empire State Group Team: is is a request to complete all of the Fassst! Formation Package: 1. Form my LLC; 2. Acquire my Employer Identification Number; 3. Customize my Bank Operating Agreement (one member); 4. provide a Certificate of Status (a/k/a Certificate of Good Standing) LLC’s Name —1st Choice: Choose a County: Other LLC Name Choices: My choice of Registered Agent service: o 1 year at $199; o 2 years at $399; o 3 years at $499. (receive notice of urgent documentation; keep your anonymity; help avoid identity theſt; preclude junk-mail innundation) My Name: My Company: My Company Address: City, State & Zip Code: My Phone: My E-Mail: TOTAL COST = SIGNATURE REQUIRED: X I am paying via ZELLE. The e-mail address for payment is publish@empirestatelegal.com Please charge this purchase to my credit/debit card, either VISA, AMEX or DISCOVER: Cardholder Name: Company: Cardholder Address: Phone Number: Card Number: Expiration: CV V: Payment Authorizing Signature: X If paying by credit/debit card, the above is my credit/debit card and with my signature I authorize payment for the above request.