DOCUMENTAL SEARCH HOUSE
4915 Bathurst St. Suite # 209. North York, Ontario. M2R 1X9
Phone: (416) 226-1163 Fax: (416) 226-0013

ORDER FORM

Corporate Name Search Report - NUANS $39.95 _____ (plus tax)

Preliminary Name Search $ 15.00 _____ (plus tax)

Please write clearly in CAPITAL LETTERS or type

1. Date _______________

2. Proposed Corporate Name to be searched:___________________________________________

3. Nature of proposed business:______________________________________________________
(computer, clothing, restaurant, etc.)

4. Federal: _____________ or Provincial _____________

5. Profit or Non-Profit : _____________________________

6. Your name : ________________________________________________________

Address : ____________________________________________________________

Telephone Office : ____________________________ Home :___________________________

Fax :__________________________

7. Payment method : (required for faxed orders)

Credit card # _______________________________________ Expiry date :_____________

Account name _______________________________ and #________________

8. Delivery options :

Pick-up _________ Rush_____________ or Overnight ___________

___________________________________
Signature

__________________________________________
Full Name