Expedited Service Request - Secretary Of The State - Connecticut

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FINANCIAL UNIT USE ONLY
EXPEDITED SERVICE REQUEST
AMT. REC’D
$
CA CR
All Entities
TRANS. ID
BATCH DATE
Website Address:
Telephone Number: (860) 509-6003
Mailing Address:
Connecticut Secretary of the State, Commercial Recording Division
P.O. Box 150470, Hartford, CT 06115-0470
Courier Delivery Address ONLY:
Connecticut Secretary of the State, Commercial Recording Division
(i.e. FedEx, UPS etc.)
30 Trinity Street, Hartford, CT 06106
USE INK. COMPLETE ALL SECTIONS. PRINT OR TYPE. (Attach 8 ½ x 11 sheet if necessary)
1.
NAME OF BUSINESS:
2.
NAME AND ADDRESS OF PARTY REQUESTING SERVICE:
3.
CUSTOMER ID (IF APPLICABLE):
CHECK HERE TO DEBIT ACCOUNT
4.
CHECK ONE:
MAIL
PICK UP
5.
CHECK EXPEDITED SERVICE BEING REQUESTED BELOW
GENERAL FILING:
REVIEW OF DOCUMENT
EXPRESS
CERTIFICATES OF LEGAL EXISTENCE:
SHORT FORM
)
(Reflects name changes – not available for Limited partnerships
__________
COPIES:
PLAIN
CERTIFIED
NUMBER OF COPIES
Type of Document
Filing Number
Date
Volume
Page
Payment Amount: $_____________________
Method:
Cash
Check #__________
MASTERCARD or
VISA
Credit Card #____________________________
Exp. Date____________ Zip Code___________
Revised 7/23/2008

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