| Fill out your COMPANY
NAME:
Exactly as you want it to appear on kit binder. |
. |
| Choose product | __ $35 INC Kit with embossing
seal and shares
__ $30 Embossing seal only |
| Shipping
International Shipping |
_x_ $30 for UPS Ground
___ $40 Canada Ground (5 business days) ___ $65 Canada Overnight ___ $89 Western Europe and the Far East 3-4 days ___ $137 Eastern Europe.5-6 days ___ $71 Mexico and the Carribean. 3-4 days. ___ $115 South America 4-6 days. ___ $91 Australia 4-6 days ___ $87 Saudi Arabia, Middle East, Africa and China 5-9 days |
| Total Number of Authorized Shares: | . |
| Par Value Per Share in dollars: | $ |
| Type of Shares: | __ Common or __ Preferred |
| Title of Officers who will sign certificates: | __ President __ Treasurer __ Secretary
__ Vice President |
| State of Incorporation: | . |
| Date of Incorporation: | . |
| TOTAL: | . |
PAYMENT INFORMATION:
I authorize Eastbiz.com, Inc. to
debit my credit card.
| Check one: | __ VISA __MasterCard __ Discover __ AMEX |
| Credit Card Number: | . |
| Expiration Date: | . |
| Name on the card: | . |
| Billing address: | . |
| City and State | City State ZIP code |
Signature Of Card Holder______________________________ (Signature is required)
CONTACT INFORMATION
| Contact Name | |
| Phone, fax | Phone: Fax: |
| Email: | |
| Mailing address: | |
| City and State | City State ZIP code |