Corporation 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
Shares of Common Stock:
Corporate Director #1
Corporate Director #1
Address
Address (continued)
City
State
Zip Code
Annual Compensation
Add another Corporate Director?
Corporate Director #2
Corporate Director #2
Address
Address (continued)
City
State
Zip Code
Annual Compenation
Add another Corporate Director?
Corporate Director #3
Corporate Director #3
Address
Address (continued)
City
State
Zip Code
Annual Compenation
Add another Corporate Director?
Corporate Director #4
Corporate Director #4
Address
Address (continued)
City
State
Zip Code
Annual Compenation
Corporate Officers
President / CEO
President / CEO
Address
Address (continued)
City
State
Zip Code
Phone (xxx-xxx-xxxx)
Annual Compensation
Secretary / COO
Secretary / COO
Address
Address (continued)
City
State
Zip Code
Phone (xxx-xxx-xxxx)
Annual Compensation
Treasurer / CFO
Treasurer / CFO
Address
Address (continued)
City
State
Zip Code
Phone (xxx-xxx-xxxx)
Annual Compensation
Vice President
Vice President
Address
Address (continued)
City
State
Zip Code
Phone (xxx-xxx-xxxx)
Annual Compensation
Other Corporate Officer #1
Other
Address
Address (continued)
City
State
Zip Code
Phone (xxx-xxx-xxxx)
Annual Compensation
Add another Corporate Officer?
Other Corporate Officer #2
Other #2
Address
Address (continued)
City
State
Zip Code
Phone (xxx-xxx-xxxx)
Annual Compensation
Shareholder #1
Shareholder #1 Name
SSN
Number of Shares
Address
Address (continued)
City
State
Zip Code
Name of Spouse
Spouse SSN
Add another Shareholder?
Shareholder #2
Shareholder #2 Name
SSN
Number of Shares
Address
Address (continued)
City
State
Zip Code
Name of Spouse
Spouse SSN
Add another Shareholder?
Shareholder #3
Shareholder #3 Name
SSN
Number of Shares
Address
Address (continued)
City
State
Zip Code
Name of Spouse
Spouse SSN
Add another Shareholder?
Shareholder #4
Shareholder #4 Name
SSN
Number of Shares
Address
Address (continued)
City
State
Zip Code
Name of Spouse
Spouse SSN
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?
back submit
