C010.002 Arizona Corporation Commission – Corporations Division
Rev: 2013 Page 3 of 3
9.
Name
Address 1
Address 2 (optional)
City State Zip
Country
SIGNATURE – see Instructions C010i:
I ACCEPT
Signature
Printed Name Date
IF SIGNING FOR AN ENTITY, CHECK ONE, FILL IN BLANK:
Corporation as Incorporator - I am signing as an
officer or authorized agent of a corporation and its
name is:
LLC as Incorporator - I am signing as a member,
manager, or authorized agent of a limited liability
company , and its name is:
Name
Address 1
Address 2 (optional)
City State Zip
Country
SIGNATURE –
see Instructions C010i:
I ACCEPT
Signature
Printed Name Date
IF SIGNING FOR AN ENTITY, CHECK ONE, FILL IN BLANK:
Corporation as Incorporator - I am signing as an
officer or authorized agent of a corporation and its
name is:
LLC as Incorporator - I am signing as a member,
manager, or authorized agent of a limited liability
company, and its name is:
Filing Fee: $60.00 (regular processing)
Expedited processing – add $35.00 to filing fee.
All fees are nonrefundable - see Instructions.
Mail: Arizona Corporation Commission
Corporate Filings Section
1300 W. Washington St., Phoenix, Arizona 85007
Fax: 602-542-4100
Please be advised that A.C.C. forms reflect only the minimum provisions required by statute. You should seek private legal counsel for those matters that may pertain to
the individual needs of your business.
All documents filed with the Arizona Corporation Commission are public record and are open for public inspection.
If you have questions after reading the Instructions, please call 602-542-3026 or (within Arizona only) 800-345-5819.
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REQUIRED - you must complete and submit with the Articles a Certificate of Disclosure.
The Articles will be rejected if the Certificate of Disclosure is not simultaneously submitted.
By checking the box marked "I accept" below, I acknowledge
under penalty of perjury that this document together with
any attachments is submitted in compliance with Arizona law.
By checking the box marked "I accept" below, I acknowledge
under penalty of perjury that this document together with
any attachments is submitted in compliance with Arizona law.
10.
INCORPORATORS - list the name and address, and provide the signature, of each and
every incorporator - minimum of one is required. If more space is needed, check this box
and complete and attach the Incorporator Attachment form C084.