Colorado > Secretary Of State > Prepaid Account
Prepaid Account Application - Colorado
| Prepaid Account Application Form. This is a Colorado form and can be used in Prepaid Account Secretary Of State . |
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Business/Entity Name Business/Entity Address (Number and Street Name) (City) (State) (Zip Code) (Province and Country, if applicable) Mailing Address (If different than street address) (Number and Street Name, or P.O. Box) (City) (State) (Zip Code) Point of Contact for this account (Name) (Title) (Telephone Number, with Area Code) (Fax Number, with Area Code) E-mail Address of Contact Individuals authorized to use account (Name) (Name) (Telephone Number) (Telephone Number) (Name) (Telephone Number) Individual authorized to open account (Print Name) (Title) (Telephone Number) (E-mail Address) (Signature of Authorized Individual) (Date) The person signing for the Business/Entity named on this application hereby affirms that she/he is authorized to act on behalf of such Business/Entity with regard to use of a Prepaid Account with the Department of State, agrees to the terms and conditions of having a Prepaid Account, and acknowledges that the Department of State is relying on her/his representations to that effect. For Office Use Only Date Application Received: Amount of Initial Deposit: $ Account Number Assigned: Date Account Opened: Date Account Closed: PP Acct App Rev. 1/11/2011 American LegalNet, Inc. www.FormsWorkFlow.com
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