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Section 9

NATIONWIDE INCORPORATION
ORDER FORM

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1. Please incorporate one the following:

¨ Profit Corporation ¨ Limited Liability Company ¨ Non-Profit Corporation
¨ Professional Corporation ¨ Foreign Corporation

2. State of incorporation _________________________________________________

3. Choice of corporate names (in order of preference):

a) _______________________________________________________________________________ ¨
b) _______________________________________________________________________________ ¨
c) _______________________________________________________________________________ ¨
Are any of these names currently reserved by you?
Please indicate ones with an 'x' in the box next to the name.

4. Type of business to be pursued by company.

________________________________________________________________________________
________________________________________________________________________________
  and to engage in any lawful activity.

5. Names of directors and their addresses:

a) _______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
b) _______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
c) _______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

6. Registered agent and principal office address (Leave blank if we provide our address in the
state of incorporation for use in the articles, which is included when incorporating at no extra charge):

_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

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