CORPORATE FORMATION INFORMATION QUESTIONNAIRE

CALIFORNIA CORPORATION

To complete the formation of your corporation, we will need the following information:

1. What is your first choice for corporate name?

____________________________________________

Second choice:

____________________________________________

2. Are either of your preferred names similar to the name(s) of any other corporation in which you
participate?

Yes _____ No _____

If yes, we will need the consent of such entity in order to secure the name from the State of California.
Please give the name and address of such corporation.

____________________________________________
____________________________________________
____________________________________________

3. Please state the corporation’s anticipated principal business activity.

__________________________________________________
__________________________________________________

4. What is the location of the principal office of the corporation?

____________________________________________

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____________________________________________
____________________________________________

5. Will there be other office locations?

Yes _____ No _____

 If yes, please list the names and addresses of those offices.

________________________________________
________________________________________
________________________________________

6. What is the mailing address of the corporation?

________________________________________
________________________________________
________________________________________

7. What is the initial number of directors? (Note that if you have one shareholder you may have one
director, and if you have two shareholders you may have two directors - in all other cases you must have
three or more directors)

___________________________

8. California law allows a corporation to have a variable number of directors which may be changed from
time to time by the shareholders or the board. Would you like to provide for this type of flexibility in
the corporation's bylaws?

Yes _____ No _____

9. Please provide the name and addresses of the initial directors. (Attach a separate sheet if necessary)

Name Address

10. Please state the name and address of the corporate agent for service of process. (Must be an individual
and no Post Office Boxes)

____________________________________________
____________________________________________
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 ____________________________________________

11. Please provide the names and addresses of the officers of the corporation. (A president, secretary and
chief financial officer are required by California law, and more than one office may be held by any
individual)

Required Officers:

President: ______________________________
______________________________
______________________________

Secretary: ______________________________
______________________________
______________________________

Chief Financial ______________________________

Officer: ______________________________
______________________________

Optional Officers are: Chief Executive Officer, Chief Operating Officer, Assistant Secretary, Assistant
Treasurer, Vice President(s) (attach separate sheet for names and addresses of such officers).

12. Unless otherwise requested, only common stock will be initially issued. Do you wish to have other
types of stock issued? (Please feel free to consult us with regard to your response to this question)

Yes _____ No _____

If yes, please describe the rights and preferences you would like the additional shares to include. Your
description will be used as a basis for further discussions with you of the form of stock necessary to
meet your needs.

______________________________________________________
______________________________________________________

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______________________________________________________

13. For the initial issuance of stock, please provide the shareholder information requested on the attached
table at the end of this questionnaire. (This information will be used to complete various necessary
forms and to issue stock; attach additional sheets as necessary).

Shareholder's name and address

Spouse name and address
Social Security number
Number of shares
Class of stock
 Tax year
Amount and type of payment
(i.e., cash, promissory note,
property, services)

14. Please state the price for each share. $__________________________

15. Do you want any of the stock listed on the attached table at the end of this questionnaire to be held for
future issuance (i.e., options) or to be subject to any restrictions (i.e., right of repurchase)?

Yes _____ No _____

16. Please state the date and time you want the annual shareholders meeting to be held:

Date: ____________________________________________

Time: ____________________________________________

17. Please name the bank to be used by the corporation and its address.

____________________________________________
____________________________________________
____________________________________________
____________________________________________

18. Will more than one signature be required on checks written on behalf of the corporation?

Yes _____ No _____

Please state the number of signatures required on checks written on behalf of the corporation.

________________

19. Please name the officers who will have authority to sign checks on behalf of the corporation.

Name Office
_________________________ _________________________

_________________________ _________________________

_________________________ _________________________

20. Is this corporation the outgrowth or continuation of any form of a predecessor business? Yes _____
No _____
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 If yes, please state: name of predecessor, type of organization and period of existence.

___________________________________________
____________________________________________

21. Have you ever applied for a Federal Tax Identification number for this or any predecessor business?
Yes _____ No _____

If so, please provide us with the I.D. number: ________________________

22. Please state the number of employees that the corporation is anticipated to have in the first 12 months of
operation.

_________________________

23. Please state the date the corporation started or will start doing business.

____________________________________________

24. Many businesses end their tax year on December 31. Do you wish to have the corporation's fiscal year
end on this date?

Yes _____ No _____

If not, indicate the desired date:

________________________________________________

25. Would you like to discuss with us the option of having the corporation treated, for tax purposes, as a
pass-through entity (an "S" corporation), which, among other things, would result in the corporation
essentially being treated like a partnership? (An "S" corporation must have a December 31 fiscal year
end.)

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Yes _____ No _____

26. Would you like for us to order a customized minute book for your corporation? (Additional charges will
apply).

Yes _____ No _____

27. Would you like us to order a corporate seal for the corporation? (Corporate seals are not required by
California law; additional charges will apply).

Yes _____ No _____

28. Would you like us to have a customized share certificate printed? (Additional charges will apply).

Yes _____ No _____

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