Pacific Fidelity Inc.

6130 West Flamingo Road, #135, Las Vegas, Nevada 89103

Telephone: (702)873-8216 Fax: (240)220-1068

ORDER FORM

Organization Name: ____________________________ Fax: ______________________

Name: _______________________________________ Phone: ___________________

Street Address: __________________________________________________________

City: ____________________________________ State: ____________ Zip: _________

Corporate record book to be kept at above address? ______ Yes ______ No

If NO, give address where record book will be kept :

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If forming a new Corporation or LLC, list name and address of 2 members or 1 manager:

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Check services needed and mail to address above with check or money order, payable to: Pacific Fidelity Inc. Allow 2-3 weeks for processing Articles and 2-3 weeks for List of Officers.

All new Corporations will be formed with 2,500 shares of No Par stock, unless specific instructions state otherwise.

Comments : ______________________________________________________________

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