Panama Immigration Services
ENTITY & PROPERTY ORDER FORM

1. BUYER INFORMATION:
A. Complete Name:
B. Passport / Id. Number:
C. Complete Delivery Address:
D. City :
E. State/Province:
F. Zip Code:
G. Country:
H. Home Phone :
I. Work Phone:
J. Fax:
K. Email:
L. Second Email (optional) :
M. Preferred Method of Contact (email, telephone, or fax):
   
2. NEW ENTITY - SELECTING A NAME:
If ordering a new entity, enter three name choices below. Panama Corporations must include the prefix "Inc", "Incorporated", "Corp", "Corporation" or "S.A.". Panama Foundations must include the word, "Foundation" in the name:
Entity 1: A.
Entity 1: B.
Entity 1: C.
   
Entity 2: A.
Entity 2: B.  
Entity 2: C.  
   
3. NOMINEE DIRECTORS:
Nominee Directors are provided at no additional charge.
   
Do you wish to use Nominee Directors? Yes No
   

4. APPOINT DIRECTORS:
Nominee Directors can be provided at no additional charge. However, if you want to provide your own directors, please complete the details below. Please note that you must provide us with passport copies of each of the directors if you wish to use your own directors:
A. PRESIDENT:  
Complete Name:
Address (no PO box allowed):
City:
State/Province :
Zip Code:
Country :
Passport Number:
   
B. SECRETARY:  
Complete Name:
Address (no PO box allowed):
City:
State/Province:
Zip Code:
Country :
Country Where Passport Issued:
Passport Number:
   
C. TREASURER:  
Complete Name:
Address (No PO box allowed) :
City:
State/Province:
Zip Code:
Country:
Country Where Passport Issued:
Passport Number :
Please provide any additional details regarding directors that you wish for us to know:
 
5. CAPITALIZATION & SHARE CERTIFICATES (RE: only corporations):
Share Capitalization: US$10K Standard
Special US$
   
Special Instructions:
  
Share Title: 100% to Bearer
100% to Foundation
Special Instructions:
Note: Standard practice is to issue minimum capitalization of US$10,000, with 100% of shares issued to the Bearer or to the Foundation (if applicable).
   
6. SHARES TO BE ISSUED:  
A. Bearer Form:
B. Name:
C. Foundation:
   
7. MAIL FORWARDING SERVICES:
Would you like to use Mail Forwarding Services? Yes No
(Mail Forwarding Services includes a Corporate Mail Box and physical address in Panama City, Panama to receive mail or courier packages. The corporations mail and courier packages will be forwarded to you per your instructions. Courier or post mail forwarding costs will be billed to the corporation. Total cost is US$300 per year.
A. Complete Address:
B. City:
C. State/Province:
D. Country :
If you would like to use mail forwarding, please complete the following:
E. Zip Code:
F. Indicate the method your mail should be forwarded to you:
Courier Post Email
G. Indicate the frequency that you would like your mail to be forwarded:
Monthly Bi-Monthly Semi-Annually Annually
   
8. ADDITIONAL CORPORATE DOCUMENTS:
A. Investment Advisor Contract (Additional US$250):
B. General Manager Contract (Additional US$250):
C. Private Annuity Contract (Additional US$250):
D. Foundation Donation Forms (Additional US$50):
E. Certificate of Incorporation (Additional US$75):
Check all documents that you wish to purchase:  
   
9. PROPERTY TRANSACTION INFORMATION:
9.1. SELLER INFORMATION:  
A. Complete Name:
B. Passport / Id. Number:
C. Complete Delivery Address:
D. City :
E. State/Province:
F. Zip Code:
G. Country:
H. Home Phone :
I. Work Phone:
J. Fax:
K. Email:
L. Second Email (optional) :
M. Corporation/Foundation:
N. Entity Record information:
O. Entity Directors information:
 
9.2. PROPERTY DESCRIPTION (IF TITLED):
A. Title (Finca) Number:
B. Roll:
Document:
C. Area:
D. Location (Place, Community, Subdivision, District and Province):
   
9.3. PROPERTY DESCRIPTION (IF RIGHTS OF POSSESSION):
A. Area:
B. Location (Place, Community, Subdivision, District and Province):
9.4. TRANSACTION DESCRIPTION:
A. Total Property Purchase Price:
B. Payment form agreed:
Amount: $
Date:
C. Payments description agreed (which party agreed to pay the following):
SELLER: BUYER: DESCRIPTION:  
Seller's Attorney Fee
Buyer's Attorney Fee
Escrow Fees for Transaction (www.panamatitle.com) Registration Expenses
Property Transfer Tax (if Title)
Bank Wire Fees (if applicable)
Broker's Commission (if applicable)
Other:  
   
9.5. ESTIMATE BALANCE FOR TRANSACTION:
$ ($1,000.00) Payment for Corporation (optional)
$ ($1,000.00) Payment for Foundation (optional)
$ ($2,500.00) Payment for Complete Offshore Structure (optional)
$ ($1,200.00) Payment for Property Transaction: closing and registration
$ (varies) Payment for Notary and Government Fees for registration
$ (to Broker if any) Payment for Brokerage Commission
$ Payment to Seller for Property Purchase
$ ($62.50) Local Bank Commission if Wire Transfer
$ ($50.00) Courier Fee (if applicable)
$ (Escrow Fees) Panama Title & Escrow: www.panamatitle.com
$ Other
$ Total amount for Transaction
   
9.6. ADDITIONAL INFORMATION:
   
10. SHIPPING METHOD: Please send my Corporate Documents by:
A. Airmail (no surcharge - included with purchase):
B. Courier (US$50 extra):
   
INCORPORATION / ADMINISTRATION INDEMNITY AGREEMENT
In consideration of PANAMA OFFSHORE LEGAL SERVICES and/or PANAMA OFFSHORE SERVICES INTERNATIONAL INC. (here forward the "FIRM") agreeing to form, incorporate and/or administer one or more juridical entities (here forward the "ENTITY(S)") on my behalf,
, passport #
Citizen of
with address at
   


(here forward the "CLIENT"), hereby UNDERTAKE and AGREE to indemnify and hold harmless the FIRM, their affiliated companies and their respective owners, agents, servants and employees, and to keep them indemnified and held harmless, from any and all actions, suits, proceedings, claims, demands, costs and expenses whatsoever (whether in contract or in tort) which may be made or taken against them or any of them, in respect of them or any of them taking any action, or failing to take any action, with respect to the formation, incorporation or administration of, or otherwise in connection with, the ENTITY(S) formed by the FIRM on my behalf.

I, the CLIENT, agree to pay the FIRM for all annual fees for Resident Agent, Registered Office (if applicable), Nominee Directors (if applicable), Corporate Government Taxes (if applicable), as well as all other legal fees, government fees, taxes, or other charges, fees, or applicable costs that are associated with the services provided by the FIRM as per the agreed upon terms & conditions or schedule of fees of the FIRM. In the event of non-payment of fees to the FIRM, I agree to; (a) renounce all rights to the ENTITY(S) formed, (b) to return all original corporate documents, shares, & certificates to the FIRM, and (c) I authorize the FIRM to make all changes or registrations necessary for the ENTITY(S) to be dissolved or re-structured as per the discretion of the FIRM.

I, the CLIENT, agree that these obligations shall be binding upon my executors, administrators and successors in title. I further agree that this Indemnity Agreement shall be subject only to, and interpreted only under, the laws of Republic of Panama, and that any and all legal proceedings relating there to shall be subject to the exclusive jurisdiction of the courts of Panama, and that no proceedings shall be instituted in the courts of any other jurisdiction with respect here to.

Signature: Date: