Business Entity Intake Form

The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. We invite you to contact us and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established.

*Your Full Name:

*E-mail address:

*Your Complete Address:

*All Contact Telephone Numbers:

*Type of Business desired:

*State in which you desire to form the business:

Any other states in which you you want the Business to be qualified to do business:

Desired Effective Date of formation of the Business:

*First choice of Business Name:

*Second choice of Business Name (if first is not available):

General description of Business (i.e., goods, services, profession, etc.):

*Address of Principal Place of Business:

*Initial Registered Agent (in state of formation):

*Initial Registered Agent Address (in state of formation):

Initial Cash Capital Contribution to Business:

Description/Value of Non-Cash Capital to Business (i.e., equipment, land, etc.):

Full Names and Addresses of the Owners of the Business and their amount of shares, units or percentage of ownership:

Who do you want to manage the Business?
Members/Owners
Elected Managers
Board of Directors

Full Names and Addresses of who you want to manage the Business (i.e., owners, elected managers or directors, board of directors, etc.):

Full Names of all officers you wish to elect, if applicable, with their appropriate title next to their name (i.e., President, Vice President, Secretary, Assistant Secretary, Treasurer, etc.):

*Accounting period (i.e., calendar year(ends Dec. 31) or fiscal year ending):

Accounting basis (i.e., Cash, Accrual or Other):

What date do you desire to hold annual meeting of owners (should be within four months following the end of the annual accounting period (i.e., fiscal year end or calendar year end):

What Trade Name, if any, do you wish to use:

In what states do you wish to use this Trade Name:

Do you have or expect to have any employees within the next 12 months?
Yes
No

If yes, how many employees do you have or expect to have within the next 12 months?

What date do you expect to first pay them wages:

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