Virtual Business Address

Contact Information

First Name*

Last Name*

Address*

City*

State*

Zip Code*

Phone Number*

Email Address*

Business Information

Business Name*

Address*

City*

State*

Zip Code*

Entity Type*

State of Formation*

Business Entity Number

Virtual Address Setup

Mail Handling Options*

Scan & EmailForward Physical Mail

Hold for Pickup

Additional Notes

Create Online Account

Username or Email*

Password*

Confirm Password*

Authorization

By submitting this form, I confirm that the information provided is accurate and complete. I authorize Prime Registered Agent to use this information to prepare and file the necessary documents. I understand this submission does not constitute legal or tax advice.

I acknowledge that I am responsible for ensuring the accuracy of the information provided and for any applicable state fees unless otherwise agreed in writing.

Price

Virtual Address Service $19.00/month

Get a professional virtual business address.

Due Monthly: $19.00
Total Due Today: $19.00

Authorized Signer Name

Title/Position*

Signature / Electronic Agreement*

I authorize Prime Registered Agent to receive, scan, and forward mail on behalf of my business at the virtual address provided.

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