Belize Merchant Account Package Order.

Please order services

1. Belize Merchant Account Package *	$1,990
2. Apostille Legalization	$200
3. Certificate of Good Standing	Certificate - $250 Certificate legalized with Apostille - $450
4. Certificate of Incumbency	Certificate - $200 Certificate legalized with Apostille - $400
5. Nominee Services for one year	Nominee Shareholder - $300 Nominee Director & Power of Attorney Apostilled - $600
6. Belize Virtual Office Services	$400
7. Total amount of your order

Please enter your information

We recommend you to order a shelf company. It will save you a minimum of one week.

1. Proposed Corporate Name *
2. Alternative Corporate Name
3. Company in Shelf Company List *	No Yes Please choose one selection
4. Brief Information about your business *
5. Directors (do not fill in if you ordered Nominee Director)	First Director Name (First, Middle, Last) Address City State/Province Zip/Postal Code Country   Additional Directors (Names, Addresses)
6. Officers (do not fill in if you ordered Nominee Director)	President Name (First, Middle, Last) Secretary Name (First, Middle, Last) Treasurer Name (First, Middle, Last)
7. Individual requiring Power of Attorney (do not fill in if you are Director of the company)	Name (First, Middle, Last) Address City State/Province Zip/Postal Code Country
8. Shareholders (do not fill in if you ordered Nominee Shareholder)	First Shareholder   Name (First, Middle, Last) % of Issued Shares   Additional Shareholders (Names, % of Issued Shared)
9. Any Additional Information
10. Source of Information about our Company	Google search Bing search Yahoo search List of search houses at www.nuans.com Facebook, Twitter or YourTube Ordered your services before Referred by existing client Other
11. Your contact information *	Name (First, Middle, Last) * Address * City * State/Province Zip/Postal Code * Country * Phone * Fax Email *

I certify that the information provided is true and accurate and all individuals listed in this form are at least 18 years old, of sound mind (mentally competent) and not in a status of bankrupt. I understand and agree that submitting of this form online constitutes my electronic signature, and my electronic submission of this application shall be legally binding, such transaction shall be considered authorized by me, and the same terms that apply to a signed paper application will apply to this electronically submitted application. I accept the Terms and Conditions and assume all responsibility for legitimate usage of all documents and information I ordered from A & P Intertrust Corporation.

YES, I accept the Terms and Conditions *

Signature (enter First and Last Name): *