Special Processing {DSCB 15-153(a)(17)}

PENNSYLVANIA DEPARTMENT OF STATE BUREAU OF CORPORATIONS AND CHARITABLE ORGANIZATIONS Special Processing DSCB:15-153(a)(17) (3/1/2017) Special processing is the method by which multiple documents delivered to the Department of State on the same day will be filed in a certain order (e.g. file first, file second). Without this form and fee, documents submitted on the same day will be separated and are not guaranteed to be filed in the order desired. The fee for special processing fee is $70 (in addition to all other document filing fees and/or expedited service fees). This form must be completed and submitted with each group of documents. Entity Name: Entity Number: Requestor's Name: ______________________________________ Requestor's Address: ____________________________________ ______________________________________________________ ______________________________________________________ Specify the order in which documents are to be filed: Return Document Via: (CHECK ONLY ONE) COUNTER PICKUP MAIL EMAIL __________________________ File 1st ____________________________________________________________________ (name of entity and type of document) File 2nd ____________________________________________________________________ (name of entity and type of document) File 3rd ____________________________________________________________________ (name of entity and type of document) File 4th ____________________________________________________________________ (name of entity and type of document) File 5th ____________________________________________________________________ (name of entity and type of document) (attach additional sheets as necessary) Special Processing fee is $70 and is in addition to filing fees and expedited service fees. Payment Method: Deposit Account number ______________________________ Check By checking this box, I verify that I have read and understand the policies and procedures for Special Processing. To the best of my knowledge, the attached documents are in the proper order and are acceptable for filing as presented to the Bureau. I understand that if one of these documents is not accepted for filing, the documents to be filed after the rejected document will also be rejected. I also understand that the Special Processing fee is nonrefundable. American LegalNet, Inc. www.FormsWorkFlow.com