You can download this form in PDF format (145 Kb).
I, hereby request the constitution of a:
Panamanian Corporation Private Interest Foundation Non Profit / ONG Corporation Branch
to EpiphyCorp, in accordance with the following statements:
Full Name:
Passport:
Country:
State or Country:
City:
Address:
Postal Code:
Telephone:
E-mail:
Name Corporation or Private Interest Foundation Name
Company Objectives Activities
You must specify the name of the three (3) directors, or you can opt for us to provide this service.
I wish to be provided with the service of nominal directors by EpiphyCorp with an extra charge of $750.00 annually.
The authorized capital will be US$10,000.00 in nominal stock, if you have any special instructions please indicate so in the space below.
You can have a general Power of Attorney that allows a person besides the corporation’s directors to act in the name of the company, said person can be stated in the articles of incorporation or in a separate document:
Name of the Legal Representative:
Nationality:
Residence:
In the Articles of Incorporation In a separate private document
Address where you wish to receive the courier
I hereby declare that the Corporation / Private Interest Foundation that I am requesting, will not incur in any illicit or illegal acts in Panama or in any other place:
Yes No
I accept and commit to provide EpiphyCorp any document or information they request for their internal procedures and/or the confirmation of everything declared previously:
Date:
Signature
Also with this form you will have to send scanned by e-mail copy of the following documents: registration@epiphycorp.com: