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Name of the Company / Individual Providing the Following Information
*
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STATE OF FORMATION
*
ex: Texas
Entity Type
*
LLC
S-CORP
C-CORP
NON-PROFIT
Designator
*
Please Select
LLC
Limited Liability Company
Inc
Corp
Company Name Option 1
*
Company Name Option 2
*
Company Name Option 3
*
No. Of Members / Owners
*
Business Purpose:
*
Company Address Information:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
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Name Of First Member / Owner
*
First Name
Middle Name
Last Name
Address of First Member / Owner
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number of First Member / Owner
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email of First Member / Owner
*
example@example.com
Percent % Of Ownership
*
Name of Second Member / Owner
First Name
Middle Name
Last Name
Address of Second Member / Owner
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number of Second Member / Owner
Please enter a valid phone number.
Format: (000) 000-0000.
Email of Second Member / Owner
example@example.com
Percent % Of Ownership
Full Name, Address, Phone Number, and % of Ownership Of All Other Members / Owners
First Middle Last - Address - Phone # - #%
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Provide Full Name of the Register Agent
*
First Name
Middle Name
Last Name
Address of the Register Agent
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Other Information
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