Order Entry

               

About CCS  

List of  
Services  

Corporate 
Statutes 

Ordering
Online 

Contact Us 

Bound
Volumes

CCS Home Page 
Representation Set Up                                    

1. COMPANY NAME AND ADDRESS
Company Name
Address
City State OR Province
Country Zip/Postal Code
Telephone
Fax
*Email Address *Please enter information if you wish to retain a copy of this form.
2. COUNSEL NAME AND ADDRESS
Counsel Name
Address
City State OR Province
Country Zip/Postal Code
Telephone
Fax
3. PARENT COMPANY NAME (If applicable)
4. State of Inc.  5. Date of Incorporation  6. Fiscal Year End  7. Federal ID. # 

Communications

8. Service of Process Address
Same as Company
Same as Counsel
Use the Address Below
Company Name
Address
Attention
City State OR Province
Country Zip/Postal Code
Telephone
Fax
9. Tax & Routine Communications
Same as Company
Same as Counsel
Use the Address Below
Company Name
Address
Attention
City State OR Province
Country Zip/Postal Code
Telephone
Fax
10. Renewal Invoicing Address
Same as Company
Same as Counsel
Use the Address Below
Company Name
Address
Attention
City State OR Province
Country Zip/Postal Code
Telephone
Fax
11. SPECIAL INSTRUCTIONS FOR SERVICE OF PROCESS:
12. SPECIAL COMMENTS:
13. States doing business in:
STATE DOM
FOR
OR
SPEC 		INC/QUAL
DATE		 STATE
ID# 		TYPE
OF
SERV 		GUAR
REP
RATE		 FORCED D/B/A
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
20. SIGNATURE OF SENDER: 21. DATE: