CORPORATION INFORMATION SHEET

 

CORPORATION NAME :

        YOUR 1ST CHOICE :

        YOUR 2ND CHOICE :

        YOUR 3RD CHOICE :

TYPE:     LLC / PART. ,    LLC / CORP ,    C CORP ,    S CORP

ADDRESS:

CONTACT PERSON:

PAGER:

BUS. TEL:

BUS. FAX:

CELL:

OTHER CONTACT PERSON:

PRINCIPLE ACTIVITY:

 

 

PRESIDENT:

SHARE:

ADDRESS:

TEL

SSN#:

DRLN:

DDB:

V. PRESIDENT:

SHARE:

ADDRESS:

TEL:

SSN#:

DRLN:

DDB:

SECRETARY:

SHARE:

ADDRESS:

TEL:

SSN#:

DRLN:

DDB:

CHIEF FINANCIAL:

SHARE:

ADDRESS:

TEL:

SSN#:

DRLN:

DDB:

LICENSE REQUIRED:                                                                                                            REMARK

  1. STATE EMPLOYER NUMBER                                                           ________________________________  
  2. SELLER’S PERMIT (RETAIL:        %  / NON-TAX:       %)              ________________________________
  3.                                                                                                                 ________________________________  
  4.                                                                                                                 ________________________________
  5.                                                                                                      ______________________________

CAPITAL AMOUNT: $

SPECIAL INSTRUCTION: