Request for Board Certificate to Incorporate

Cost: $50

Please Note

Under G.S. 55B and G.S. 57C, 100% of the membership must be held by a licensee or licensees of the appropriate Board for the same professional services to be rendered in order for the Board to issue the certificate.

The Board does not provide legal counsel. If you are unsure about which corporation you would like to form please seek legal advise from an attorney who specializes in forming corporations.

Payment Options*

If mailing in payment and Articles of Organization the address to send it to is: PO Box 16885 Greensboro, NC 27416

Pay Online
Mail in Payment

Name*

Name of Licensee Forming the Corporation

Prefix First Middle Last

License Number*

Is there a second licensee?*

Yes
No

Name*

Name of Second Licensee

Prefix First Middle Last

License Number*

License Number of Second Licensee

Is there a third licensee?*

Yes
No

Name*

Name of Third Licensee

Prefix First Middle Last

License Number*

License Number of Third Licensee

Mailing Address*

This is where your certificate will be mailed.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Who should we contact with questions?*

Prefix First Middle Last

Phone*

Phone number for questions

Please attach a copy of your proposed articles of organization or incorporation*

Max. file size: 50 MB.

Email print version of completed form

Would you like a PDF version of this completed form emailed to you?*

Yes
No

Email (for PDF delivery)*

Please enter an email address to receive a copy of this completed form.

Total

Request for Board Certificate to Incorporate

New Rules Read More

Cost: $50

Please Note

The Board does not provide legal counsel. If you are unsure about which corporation you would like to form please seek legal advise from an attorney who specializes in forming corporations.

Email print version of completed form

Licensees