Limited Liability Company

Legal Information

Legal Name of the LLC *

Does the LLC have a DBA?

YesNo

Number of members in LLC *0 / 3

In which state the LLC was incorporated? *

Managing Member Information

First Name *

Middle Name (Optional)

Last Name *

Suffix Name (optional)

Title *

Activity

Closest reason for applying *

Primary Activity *

General questions

Does your business own a highway motor vehicle weighing 55,000 pounds or more?

NoYes

Does your business involve gambling?

NoYes

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

NoYes

Does your business pay federal excise taxes?

NoYes

Has this LLC ever received or applied for an EIN before?

NoYes

Do you currently have, or plan to hire employees within the next year (not including owners)? *

NoYes

Corporate Address(PO Boxes are not authorized)

Address *

City *

State *

Zip Code *

Country *

Do you want to receive your mail at another address?

NoYes

Dates

Date entity was started or acquired *

Closing month of accounting year

Applicants Contact Information

Mobile Phone Number *

Email Address *

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