Free Form - Nevada

ROSS MILLER Secretary of State 202 North Carson Street Carson City, Nevada 89701-4201 (775) 684 5708 Website: www.nvsos.gov
SUBMIT THIS COMPLETED FORM WITH YOUR FILING

1 or 2-Hour Expedite Customer Order Instructions
USE BLACK INK ONLY - DO NOT HIGHLIGHT

Processing Service Requested:
Name of Entity:

2-Hour Expedite
(additional $500.00 fee included)

1-Hour Expedite
(additional $1000.00 fee included)

Date:

Return to: Contact Name: Return Delivery: Email to: Hold for Pick Up Other: (explain below) Mail to Address Above Fax to: FedEx: Acct # Phone:

Order Description: (include items being ordered and fee breakdown)*

*PLEASE NOTE: this office keeps the original paperwork. The first file stamped copy ordered at the time of filing is at no charge. Each additional copy is $2.00 per page (plus $30.00 for each certification).

Total Amount:

Method of Payment: Check/Money Order eCheck/Credit Card (attach checklist) Trust Account:

Use balance remaining in job # Reset
Nevada Secretary of State 1-2 Hr Customer Order Instructions Revised: 9-25-08