Rubio, Alvarez, Solis & Abrego, Attorneys at law, Panama Republic of Panama

Incorporation Form for Panamanian Corporation

1. CORPORATE NAME
Please indicate the requested name(s) with at least two additional alternate choices:

1)
2)
3)

2. CORPORATE OBJECTIVE(S)
Companies may be incorporated with general, wide-ranging corporate objectives. If you wish to incorporate the company with a more specific objective, please describe below.

3. CORPORATE DIRECTORS AND OFFICERS
If you wish to propose a specific director and/or officers for the company please provide the necessary corresponding information. A minimum of three directors or officers is required. Nominee directors and officers can be provided by Rubio, Alvarez, Solis & Abrego

Name	Nationality	Address	Position

4. INSTRUCTIONS FOR THE ISSUE OF AUTHORIZED CAPITAL
*In Panama , authorized capital may be divided into shares without par value.

Amount of shares to be issued:

Number of share certificates to be issued:

Types of shares: Bearer Registered

For registered shares or for shares of differing amounts, please provide the following information:

No. of Certificate	Name of Shareholder (if not bearer)	Address	Number of Shares

5. POWER OF ATTORNEY
Please indicate the type of power(s) of attorney (if needed):

Special

General

Issued in favor of:

Name	ID # and Type	Address

Please indicate any specific instructions for special power(s) of attorney:

6. SPECIAL PROCESSING INSTRUCTIONS
Please indicate if any special processing of the incorporation documents will be required:

	Notarization
	Notorization and legalization by the consulate of
	Apostille

Please indicate for which documents the above-noted processes are necessary:

7. AUTHORIZED PERSONS
Please provide the names of all persons authorized to access corporate information:

Name	Company	Address

Tel	Fax	E-mail

8. MAILING INSTRUCTIONS
For corporate documents:

Name	Company	Address

Tel	Fax	E-mail

For invoices:

Name	Company	Address

Tel	Fax	E-mail

9. REQUIRED DOCUMENTATION
For individual clients, the following information is required.

Name	Address	# de Passport

(Please include a copy of the passport.)

For institutional clients the following information is required.

Name of the Company	Officer in Charge

For both individual and institutional clients, please provide your e-mail address:

10. REFERENCES

1) Bank
2) Commercial:
3) Personal:

11. TERMS AND CONDITIONS
I hereby declare that all the information I have provided in this form is true and correct and that the company I wish to incorporate will not be used for drug trafficking, terrorism or money laundering. I affirm that I have received legal advice from lawyers in the place of operation of this company, or in the case of institutional clients, that a recommendation to obtain legal advice was suggested to the clients.

Signature:		Date:
Name:		Email: