State where incorporation is to happen:
Proposed name of corporation:
Alternate (required):
Address:
		City	County	State	Zip
Phone*/Fax*:		(      )        -                                   (     )       -
Amount of Retirement funds to be invested:
Officers:		Name:		SSN#:
	President:
	Secretary:
Fee is usually $900 plus fees, which generally range from $200 to $300

FAX COMPLETED FORM TO: 714-378-9658
Address above will be used for Fedex shipping unless otherwise requested.

�2001-2002 SDCooper Company Last modified on: 28-May-2004