LLC Package
Which package do you wish to purchase?
Personal Information
First Name
Last Name
Address
Address(additional)
City
State
Zip Code
Country
Billing Information
First Name
Last Name
Address
Address(additional)
City
State
Zip Code
Country
Registered Agent
Would you like Registered Agent Services for $189.00 for the 1st year (provided by our affiliate NRAI)?
Contact Name
Business Name
Address (must be a physical location within the state of formation. No Post Office Boxes accepted):
Address (continued)
City
State
Zip Code
Preferred Name of Entity
Alternative Name of Entity
Contact Person
Title
Phone Number
Email Address
Principle Place of Business
Street Address
Street Address (continued)
City
State
Zip Code
Business Purpose & Members
Business Purpose
Number of Units of Member Stock
Member #1
Member #1
Address
Address (continued)
City
State
Zip Code
Ownership Interest (%)
What will the member give in exchange for the percentage:
Other? Please explain...
Address
Member #2
Member #2
Address
Address (continued)
City
State
Zip Code
Ownership Interest (%)
What will the member give in exchange for the percentage:
Other? Please explain...
Add another member?
Member #3
Member #3
Address
Address (continued)
City
State
Zip Code
Ownership Interest (%)
What will the member give in exchange for the percentage:
Other? Please explain...
Add another member?
Member #4
Member #4
Address
Address (continued)
City
State
Zip Code
Ownership Interest (%)
What will the member give in exchange for the percentage:
Other? Please explain...
Business Purpose & Members (cont.)
Will any of the members also be employed by the LLC?
If yes, who will be employed, what are the duties and what are their salaries?
Are there any decisions that the LLC will make which requires the participation/vote of persons not listed as a member?
Manager #1
Manager #1
Address
Address (continued)
City
State
Zip Code
Compensation
Add another manager?
Manager #2
Manager #2
Address
Address (continued)
City
State
Zip Code
Compensation
Add another manager?
Manager #3
Manager #3
Address
Address (continued)
City
State
Zip Code
Compensation
Add another manager?
Manager #4
Manager #4
Address
Address (continued)
City
State
Zip Code
Compensation
Employer Identification Number
Principal Officer:
Social Security Number (xxx-xx-xxxx)
Date Business Started (YYYY/MM/DD)
Closing Month of Accounting Year
First Date Wages will be Paid (YYYY/MM/DD)
Highest Number of Employees expected in the next 12 Months
Is the Principal Business activity Manufacturing?
To Whom are Most of Your Products / Services Sold
Principal Activity
What will you be selling?
Has Applicant ever applied for EIN before?
If yes, When? City? Number?
Address
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