Corporate Capital Inc. Custom Order Form

Order Form Instructions
* When filling out this order form a "*" to the left of the option indicates Required Fields listed below.
* When typing Name of Incorporation type exactly as you wish it to appear on the Stock Certificates, Binder & Seal.
* Mo. Day, Yr. required for CA and HI only; all other States Year only applies.
* When typing Total Authorized Shares use numbers only (i.e. 10000).
* Signature Titles are listed in ranking order of the officers of the Corporation. The highest ranking officer is placed on the bottom right of the Certificate, followed by bottom left, top right and top left.
i.e.
Secretary            Treasurer
Vice President     President