Florida Incorporators, Inc.

Use this form if  your browser cannot handle forms, or if you are uncomfortable submitting a form online. Just copy this form, fill it out on your computer and e-mail it to us as a text or zipped file, or print it, fill it out and fax it to us at (305) 402-3141. We also accept filings by mail. 

Tell us about your company:

• Note: all fields are required to complete your order 
  
  [1.1] Choose a Name for your LLC (be sure to see the FAQs on choosing a name): 
  
  _____________________________________________________________ 
   
  [1.2] Please choose an alternate name in case your first choice is taken:

 ____________________________________________________________ 

 
[2] Tell us where you want us to send mail (will also be used as the LLC's principal place 
of business and must be a street address): 

 [2.1] Your Name: 
_________________________________________ 

[2.2] Company Address: 
_________________________________________ 

_________________________________________ 

[2.3] City: 
_________________________________________ 

[2.4] State: 
_________________________________________ 

[2.5] Zipcode: 
_________________________________________ 

[2.6] Phone: 
_________________________________________ 

[2.7] FAX: 
_________________________________________ 

[2.8] Second Phone: 
_________________________________________ 

[2.9] E-mail: 
_________________________________________ 

 
[3] Tell us who the Managers / Managing Members will be. We will have to state whether 

 the managers will be owners (managing members) or non-stakeholder managers: 

 [3.1] Name: ______________________________________ 

Manager or Managing Member? ____________________ 

[3.1.1] Address: 
 
_________________________________________ 

_________________________________________ 

_________________________________________ 
 
[3.2] Name: _______________________________________ 

Manager or Managing Member? ____________________ 

[3.2.1] Address: 

_________________________________________ 

_________________________________________ 

_________________________________________ 

[4]   Registered Agent Name and Address if other than Florida Incorporators, Inc. 

         (note - Registered Agent Services are mandatory for out-of-state customers):

           [4.1]  Name: ___________________________________________ 

                    Address: _________________________________________

                                    __________________________________________

                                    __________________________________________

Tell us what your Effective Date of Incorporation for your LLC will be: __________________             

Your LLC will be filed effective upon the State's receipt unless you choose a later date no further than 90 days out.   

Florida Incorporators, Inc. is a filing service and has not provided any legal 
advice in the formation of this corporation. 

If you disagree with this statement, we cannot form your corporation or LLC.

Please Initial one:  Agree____________ Disagree___________ 

_____ Rush LLC Special   $391.25 (save $40!)  ( Includes: Rush LLC, Rush SS4 and Corporate Kit)                         

                 (rush turnaround time approx 24-48 hours)

 **FAX AND EMAIL MANDATORY FOR ALL RUSH ORDERS!

_____ ADD Registered Agent  ($50 per Year)

Al-A-Carte Ordering:                                                  

                   Florida LLC Incorporation  ($271.25)  (non-rush turnaround time approx 2 weeks)
                   Corporate Kit ($50)
                   Rush Service ($50) 

 (rush turnaround time approx 24-48 hours)

 **FAX AND EMAIL MANDATORY FOR ALL RUSH ORDERS! 
                   Delivery outside the continental USA via Overnite Courier (
00) 
                   Prepare IRS form SS-4 to obtain federal tax ID Number (
0)

                   Rush Service for SS-4 Tax ID ($40)
                   Registered Agent Service (mandatory for out-of-state customers) ($50 per year)
                   Phone call regarding items received as registered agent ($25 per year)

Total of Charges:  _______________________

[6]   If you are paying by credit card enter your information here.
      We do accept checks, however, only money orders or cashier's checks 
      will be exempt from a 14-day hold for funds to clear before processing the corporation.

   [6.1] Exact Name on Card:
        _________________________________________

   [6.2] Exact Card Number:
        _________________________________________

   [6.3] Month of Expiration:  __________________

   [6.4] Year of expiration: ____________________

   [6.5] Please indicate MasterCard, Visa or American Express:

 _________________________________________ 
 
To avoid delay, all questions should be answered fully. 

Your e-mail address and telephone number are especially important in the 
event of a possible question.

 FAX FORM TO: 305-402-3141

MAIL FORM TO: 
Florida Incorporators, Inc. 
8875 Hidden River Parkway Suite 300 
Tampa, FL 33637-2087

EMAIL FORM TO: startnow@flacorps.com 

Have questions?  See our Frequently Asked Questions Page