LLC Information Form 2021 Rev

Information Form for Limited Liability Corporation Filing Filing Fees are according to the STATE the LLC is Filed
Name of Limited Liability Company
Name of LLC Owner
Name of LLC Co-Owner
Street Address (NO PO BOX)
City
Zip
MAILING ADDRESS(IF DIFFERENT FROM ABOVE)
Address

PO Box Address

Street Address Line 2

City, State, ZipState / Province

Postal / Zip Code
Phone Number
County
Email address
example@example.com
Employer Identification Number (EIN #)
Please provide Social Security number for SS 4 application for EIN#
What is the purpose of your LLC?:

MarketingSell ProductPersonal DevelopmentLandscapingCateringOther (please specify)
Purpose Statement
By signing below, I hereby acknowledge that I have completed this form to the best of my ability.

Clear
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Should be Empty: