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Personal Information
Name
*
First Name
Last Name
Do you have a preferred name?
Cell phone number
-
Area Code
Phone Number
Home phone number
-
Area Code
Phone Number
Which is you preferred phone?
*
Cell Phone
Home Phone
Personal email
*
Work email
Which is you preferred email?
*
Personal Email
Work Email
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is your preferred method of contact?
*
Phone
Email
What is your preferred method for a meeting?
*
In Person
Virtual Meeting (Skype, etc)
Phone Call
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Entity Information
Type of Entity
*
Corporation
LLC
LP
Do not know
How Taxed
*
C-Corp
S-Corp
Partnership
Non-Profit
Sole Proprietorship
Do not know
Which State do you wish to legally form the entity
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
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
Purpose of Entity
*
Entity Name Choice No. 1
*
Alternative Entity Name Choice No. 2
*
Alternative Entity Name Choice No. 3
*
Will you operate/conduct business under a name that is different than the full legal name of the entity (i.e. DBA)
*
Yes
No
Business Address (if different from client's address above)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
If known, please list the name and address of the registered agent for the new entity:
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Entity Information
Please list who you intend to be the initial manager(s) if forming an LLC, responsible for management of the company and initial salary (if any):
How many manager(s) or director(s)?
*
1
2
3 or more
Manager - Name
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Manager - Email Address
*
Manager 2 - Name
Manager 2 - Address
Manager 2 - Email Address
Manager 3 - Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Manager 3 - Email Address
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Page 5 of 5
Do you have a working monthly budget?
*
Yes
No
Do you have a financial professional?
*
Yes
No
Any other information you feel we should know?
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