for properly completing a
Only use this form if sending to our office by mail or courier service. If you wish to pay by Credit Card
or ACH DO NOT complete this form. Please use our Document Upload Service located at
Mark the appropriate priority box. (additional Expedited Cost)
Fees: Priority 1 (One hr) - $1000.00
Priority 2 (Two hr) - $ 500.00
Priority 3 (Same Day) - Varies – Please see fee schedule
Priority 4 (24 hour) - Varies – Please see fee schedule
Completely fill out your individual or business/firm name and complete address. The attention line needs to
be completed if a business or firm name is listed. Please include a phone number and/or email address in
case our office needs to contact you.
The account number is only to be completed by submitters that have an existing Depository account
with the Division of Corporations. Please ignore this field if you do not have a Depository account.
Certification Request Information
Complete the name of the entity and the entity File number. If you do not have the file number, you
may leave it blank.
Type of Certificate Request
Please mark the item(s) requested. If you need to specify additional information or instructions, please
provide the information in the Comments/Filing Instructions section.
Method of Return Information
All documents are returned Regular Mail or you can provide a Fed-X or UPS account number for express
mail. Please mark the appropriate method of return.
Please contact our office at 302-739-3073 with any questions or for verification of fees.
Return forms and memos to:
Delaware Division of Corporations
401 Federal Street - Suite 4
Dover, DE 19901