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Cover Sheet for Corporate Filings (North Carolina)

This is a cover sheet for business and non-profit corporate filings. The form provided here is simply a sample of what the actual Form BN-01 looks like.

North Carolina Department of the Secretary of State

CORPORATIONS DIVISION
P.O. BOX 29622
Raleigh, NC 27626-0622
(919) 733-4201 or Toll Free 1-888-246-7636
www.secretary.state.nc.us

Personal Name: _________________________________

Phone: ______________________

Business Name: _________________________________

Mailing Address: _________________________________

_________________________________

Email Address: _____________________________

Fax:______________________________

Check One:

____ Same Day Guaranteed Filing (additional $200; document received by 12:00 NOON in proper form)*

____ 24-hour Guaranteed Filing (additional $100; document received in proper form)*

____ Regular Process

Check One:

____ Pick up

____ Mail to above

*Filing time guaranteed only; documentation may not necessarily be completed.

FILINGS ONLY:

Name of Entity: ______________________________________

Type of Document: ______________________________________

ORDERS ONLY:

Name of Entity: ______________________________________

Certificates: (Please check box.)

____ Existence

Quantity: ________

____ Other (specify) ______________________________________

Quantity: ________

Copies: (Please check box.)

____ All documents on file

Certified (quantity) ________

Plain (quantity) ________

____ Annual Reports

Certified (quantity) ________

Plain (quantity) ________

____ Other (specify) ______________________________________

Certified (quantity) ________

Plain (quantity) ________


Special Notes:

______________________________________

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