Business Registration Form

Please indicate your registration reason*

Application for a new businessApplication for a new location of an existing businessAmended application for an existing businessOther

Entity Name/Legal Name*

Re-Enter Entity Name/Legal Name*

Doing Business As/Fictitious Name (If Applicable- Please note most states charge an additional fee to register a DBA. If applicable, an invoice will be sent requiring additional charge prior to application completion)

Federal Tax Identification Number (If Applicable. For new registrations, enter N/A)

Business Owner's Social Security Number (This is needed to apply for and receive your EIN from the IRS)*

Type of Business Entity*

Limited Liability Company

State of Organization*

Principal Place of Business (Please note this information will be public information)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Business Phone Number*

Area CodePhone Number

Business Fax Number

Area CodePhone Number

User Name*

Password- Minimum 10 characters and must contain at least one upper and lowercase letter, at least one number and a special character*

Re-enter Password*

Full Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Full Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email

example@example.com

Phone Number

Area CodePhone Number

One- Time Payment: The $150 fee is the processing fee only. The state filing fee will be charged separately, but on the same card and under this same authorization. The amount of the filing fee will be sent via email for approval prior to any payment being processed as it varies based on the state the business is being registered in. Please choose your payment option:*

Charge to Card Below: $150 plus state filing fee- confirmed via email before payment is processedReceive Invoice for Processing Fee and State Filing Fee (Please note there will be a 3.9% fee added for invoicing)

Cardholder Name

First NameLast Name

Card Type

Card Number

Card Expiration (Enter 01 for day. Enter Month and Year as it appears on your card)

Date

Security Code (Located on Back of the Card)

Card Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

I, {Cardholder as provided above and printed and signed below}, hereby authorize DCG Enterprises, LLC to charge my credit card for the Processing Fee and State Filing fee each as a one time payment to register my business with the state. I understand these two fees will show as separate fees being charged on my card. I confirm that the information for the credit card and billing address is complete and accurate and that I am the authorizing party for the provided card. I understand that once processed and my business is registered, the payment is non-refundable. I also understand that fraudlent chargebacks will be prosecuted as theft of services. I understand that the business information listed by me above will be registered exactly as I have provided it, and if there are discrepencies with the information I have provided once registered, I will be reponsible for paying the state fee for amending the information, as well as a $75 charge to DCG Enterprises, LLC to process the change. I have been advised that my processing fee includes processing for business registration with the state, filing for my Federal Tax ID Number with the IRS, and registering for my Dun and Bradstreet Number. I understand that the full process once the completed form is received can take 5-7 business days, not including weekends or holidays, and I agree to allow this time for processing.

Please upload a Photo ID*

Browse Files

Date*

Date

Printed Name*

Signature*

Business Entity Registration Form

Site Log-In Credentials

Registered Agent Information

Business Owner

Card Authorization Form