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Expedited Service Request DSCB 15-153 - Pennsylvania

Expedited Service Request Form. This is a Pennsylvania form and can be used in Miscellaneous Department Of State .
 Fillable pdf Last Modified 4/11/2014
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DSCB: 15-153(a)(16) Bureau of Corporations and Charitable Organizations EXPEDITED SERVICE REQUEST This form MUST be completed and submitted with EACH expedited request. EXPEDITED REQUESTS MUST BE SUBMITTED IN PERSON. Entity Name: Entity Number: Requestor's Name: Requestor's Address: Return Document Via: (CHECK ONLY ONE) COUNTER PICKUP EMAIL - Completed filings will be emailed to the email address supplied below. Contact Person:______________________________________ Phone Number:______________________________________ Fax Number: ________________________________________ Email: _____________________________________________ Select the Level of Expedited Service: EXPEDITED SERVICE FEES ARE IN ADDITION TO FILING FEES. Expedited Fee(s): SAME-DAY SERVICE (MUST BE RECEIVED BEFORE 10:00 a.m.) THREE-HOUR SERVICE (MUST BE RECEIVED BEFORE 2:00 p.m.) ONE-HOUR SERVICE (MUST BE RECEIVED BEFORE 4:00 p.m.) $100.00 $300.00 $1,000.00 Payment Method: Deposit Account #_____________________ Check Credit Card By checking this box, I verify that I have read and understand the policies and procedures for Expedited Services published in the Pennsylvania Bulletin. To the best of my knowledge, the attached document is acceptable for filing as presented to the Bureau. I understand that if this document is not accepted for filing, the expedited service fee and the filing fee(s) are nonrefundable. 12/2013 American LegalNet, Inc. www.FormsWorkFlow.com
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