CORPORATE KIT ORDER FORM (fax to (352) 528-0367)

Name Of  Person To Contact:

Last

First

Firm Or Corporation:

 Email Address

Phone Number

Fax Number

 Address 1

 Address 2

City

State

 Zip Code

County
How To Be Shipped:  

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Shipping Area Is: 

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Name of Corporation:
Number Of Shares:

Share ParValue:

State:

Year Incorporated:
C-1


(W/Printed Minutes)

LLC C-1
(W/Printed Minutes)

Non-Profit
 C-1
(W/Printed 
Minutes)
C-2
(W/Blank Minutes)

LLC C-2
(W/Blank Minutes)

Non-Profit
 C-2
(W/Blank 
Minutes)
Seal Only

Stocks Only

Color of Stock Paper:


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Starting Number: Ending Number:

Special Message, if any:

STATE SEAL CERTIFICATE OF LEVY COUNTY, INC.
A/C PRINTING & RUBBER STAMP CO.
23 EAST NOBLE AVENUE ° WILLISTON, FL  32696
PHONE:  (352) 538-0845   1-800-366-5174   FAX: (352) 528-0367