Success Date Questionnaire

Your Contact Information

Name*

First Last

Email*

Order #*

Get this from your order confirmation email. #xxxxx.

Phone

City State / Province / Region Country

Your Data

Your Profession*

Your Birth Date*

Your Birth Location*

City State / Province / Region Country

Your Birth Time (if known)

:

Your Birth Time is:*

From birth certificate
From memory or estimate
Unknown or unavailable

Corporation/LLC Business Partner's Data

If no partners, skip down to Corporation/LLC Information.

Partner's Name

First Last

Partner's Profession

Partner's Birth Date

Partner's Birth Location

City State / Province / Region Country

Partner's Birth Time

:

Partner's Birth Time is:

From birth certificate
From memory or estimate
Unknown or unavailable

Date you met your business partner

(if applicable)

Corporation/LLC Information

Primary Business of New Corporation/LLC*

Additional Businesses of New Corporation/LLC

Original Start Date of Business (if applicable)

If already incorporated, use incorporation date. If there are also subsequent incorporation dates, enter subsequent dates in comments section below. If not incorporated, use founding date, DBA date, announcement date, or other significant date of initiation. Please indicate what type of date is shown in comments below.

Physical Location of New Corporation/LLC*

City State / Province / Region Country

Incorporating or Filing In:*

State / Province / Region Country

Filing Method:*

Online Filing: Be SURE you can do everything you need to do, even on a weekend or holiday, if you choose this option!

In person or via service - weekdays only, no legal holidays
Online - Filing personally online. Any day or time OK. Using a 3rd party service usually delays processing and results in the wrong date.
Mailing - any day OK (Last choice, as the receipt and filing date cannot be controlled.)

Date Preferences

35+ years of research has proven that timing is everything! Do you prefer:

Option A: The best date for super-success. Your date will be chosen as close to your ideal time frame indicated below as is consistent with choosing a super-successful date. Spectacular dates for incorporation for a particular type of business are infrequent. * I urge you to choose this option. 30 years of research clearly shows that regardless of other considerations, it is far better to wait for a great date that will bring super-success to your business.

OR Option B: The best date available in your time frame indicated below. *I DO NOT recommend this- but if you must....... The best date available in your specified time frame may or may not meet all the stringent requirements for a Super-Success date, but will still be the best available within your limitations. Bear in mind that the longer your specified ideal time frame, the greater the chances of finding a super-successful date.

Your Preference:*

Option A: The most Super-Charged date
Option B: The best date available within my limitations

Ideal Time Frame Begins*

Be SURE you'll be ready to take action by this date. Your chosen date could possibly be found on this date or shortly after.

Ideal Time Frame Ends*

Longest Possible Time Frame Begins*

Be SURE you'll be ready to take action by this date. Your chosen date could possibly be found on this date or shortly after.

Longest Possible Time Frame Ends*

Do Not Use This Date/These Dates

Please use American mm/dd/yyyy format.

Additional Comments or Information

Comments

Delivery

Your Super-Success Incorporation/LLC Date will be delivered via email. Please allow 6 weeks after receipt of this completed form unless you have ordered expedited delivery. Please CHECK YOUR SPAM FOLDER beginning a few days before your date is due to be delivered.