Prepaid Acct Set Up Slip

State of Alabama Office of the Secretary of State 334-242-7200 Pre-Paid Account * Set Up Slip Account Number: Account Contact Person: Telephone: Address: City/State/Zip: , Agent / Service you would like to have authorization to use this account (optional): Signature: Date: Physical Address: Alabama State House 11 South Union Street Montgomery, AL 36130 Business Services 226 Suite 119 334-242-5324 UCC 226 Suite 220 334-353-0203 OFFICIAL USE ONLY Mailing Address: P.O. Box 5616 Montgomery, AL 36103-5616 Please specify the appropriate division by inserting 223Business Services224 or 223UCC224 with the mailing address. *The minimum for setting up a pre-paid account is $500.00 for UCC and $1,500.00 minimum for Business Entities, payable only by check. The money must be debited for services to a zero balance and is non-refundable.* American LegalNet, Inc. www.FormsWorkFlow.com