IMPORTANT NOTICE to our LLC clients - Annual Delaware LLC Tax is due to the State of Delaware no later than June 1, 2017 to avoid penalties/interest.

DELAWARE REGISTRY, LTD.
SECURE GENERAL ORDER FORM

This secure general order form is for the purpose of allowing existing clients to order and remit payment for miscellaneous items.

Please place your request for services and/or agent fees in the Items Requested box.

Required fields are marked with an asterisk (*).

Please note that the order form does not recognize foreign characters. Using a foreign character when you submit your order request may cause an error in the translation and delay the processing of your request. Please only utilize the English U.S. characters on your keyboard.

CORRESPONDENCE INFORMATION

*Company Name:
*Your Name:
Care Of:
*Mailing Address: US Outside US
*Phone Number: Fax Number:
*Contact E-mail Address:
*Enter Contact E-mail Address Again:
  Confirmation of your order will be sent to this email address.

BILLING INFORMATION

   
Please enter your credit card data in the fields provided

*Name, as it appears on card:
*Select a credit card: VISA   MasterCard   Discover
*Credit Card Number:
*Credit Card Security Code/CV2: - What is this
*Expiration Date: /
*Amount of Charge: $

Billing address same as correspondence address? - Yes

*Mailing Address: US Outside US
*Phone:
*Billing E-mail Address:

*Items Requested, and address for forwarding requested documents/receipts if different than Billing Address:

Press the "Review Order" button to see a summary of what you have entered and the price totals.