Business Formation Questionnaire

Entity Name and Type

Please provide three options for desired name of the business in order of preference:

Desired Name of Business – (1)

Desired Name of Business – (2)

Desired Name of Business – (3)

Address

City

State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip

Form of Business
LLC C Corporation S Corporation Non-profit Limited Partnership LLP

A. The initial registered agent is an organization (cannot be entity named above) by the name of

B. The initial registered agent is an individual resident of the state whose name is set forth below

First Name

M.I.

Last Name

Suffix

C. The business address of the registered agent and the registered office address is

Street Address

City

State

Zip Code

Management (LLCs Only)

Will the limited liability company be managed my managers (similar to a board of directors) or by the members (the owners)?

Managers Members

Managers/Members/Directors

Please provide the name and address of the managers of the entity:

Entity or Last Name

First Name

MI

DOB

Address

City

State

Zip

EIN/SSN

Phone

Email

Title

Ownership %

Ownership Class

Please provide the name and address of the members of the entity:

Entity or Last Name

First Name

MI

DOB

Address

City

State

Zip

EIN/SSN

Phone

Email

Title

Ownership %

Ownership Class

Please provide the name and address of the directors of the entity:

Entity or Last Name

First Name

MI

DOB

Address

City

State

Zip

EIN/SSN

Phone

Email

Title

Ownership %

Ownership Class

Authorized Shares (For-Profit Corporation Only)

The total number of shares the corporation is authorized to issue is

A. The par value of each of the authorized shares is

B. The shares have no par value.

S-Corp Election

Do you want to elect to be taxed as an S-Corp? Yes No

Type of Business and Purpose

Construction

Real estate

Rental & leasing

Transportation & warehousing

Finance & insurance

Healthcare & social assistance

Retail

Wholesale-other

Other (specify)

The purpose should include at least one sentence which defines the principal activity and specific purpose for which the company is being formed (for example, what it will do to make a profit). If the business is being formed as a Special Purpose entity please list the specific reason.

Employees

Highest number of employees expected in the next 12 months?

Accounting Year

The Fiscal Year for the company is

The closing month of the accounting year is

Tax Matters Partner/Responsible Person

The IRS requires either an owner or person in authority (CEO or CFO) to be the responsible person regarding applying for an employer identification number and regarding tax matters. Please identify the individual or entity who will serve this role for your company

Entity or Last Name

First Name

MI

DOB

Address

City

State

Zip

EIN/SSN

Phone

Email

Please provide the name of your business bank.

Important Details

Does your business own a highway motor vehicle with a taxable gross weight of 55,000 pounds or more?

Does your business involve gambling/wagering?

Does your business need to file Form 720?

Does your business sell or manufacture alcohol, tobacco, or firearms?

Do you have, or do you expect to have, any employees who will receive Forms W-2 in the next 12 months?

Do you expect your employment tax liability to be greater than $1,000 in a full calendar year?