BUSINESS ENTITY FORMATION INTAKE FORM

BUSINESS ENTITY FORMATION INTAKE FORM

*Note: Questions with an asterisk (*) are required.

STEP 1: CLIENT BACKGROUND INFORMATION

Name

First NameMiddle NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Area CodePhone Number

Email

example@example.com

STEP 2: BUSINESS INFORMATION

Proposed name of business

Alternate names of the business if your first choice is unavailable

Will you operate or conduct your business under a name that is different than the full legal name of the entity being formed (DBA or subsidiary)?

Other

Desired state of organization

In what states will the business operate?

Address of the Business

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Address of the principal office of the business, if known

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Name and address of Resident Agent

The primary purpose for creating the entity is:

Other

The primary purpose of the business is:

STEP 3: DESIRED ENTITY TYPE

What issues are most important to you in choosing a business entity?

Choose the type of business entity that you would like to create:

For Federal Taxation purposes, the entity is to be treated as:

The duration of the entity is:

Other

STEP 4: MEMBERS/OWNERS

Please list all initial investors/officers/owners/members:

Rows	Name	Position Title	Address	Phone Number	Ownership Interest %
1
2
3
4
5

Are all the initial investors/officers/owners/members U.S. Citizens?

The business is to be managed by:

Will profits and losses be shared equally among the owners/members?

Other

Would you like there to be any restrictions on the transfer or sale of a owner's interest?

Who will be responsible for signing documents and entering contracts on behalf of the business?

STEP 5: ACCOUNTING INFORMATION

Have you consulted with an accountant regarding this business?

Please provide the name and address of the business accountant:

Have you taken out any loans for this business endeavor? Please describe the loan, financial institution, and its primary use below:

STEP 6: REMAINING QUESTIONS

Is there any other pertinent information regarding the entity and its members that we should be aware of?

Please provide any supporting documents here:

Browse Files

Sheri L. Montecalvo, Esq.
272 W. Exchange St. Suite 001
Providence, RI 02903
401-600-0146 direct dial
401-300-1429 (cell)
401-453-0073 (fax)
Sheri.Montecalvo@epwithsheri.com