Indiana LLC Reinstatement Intake
Full Name
*
First Name
Last Name
Email
*
example@example.com
Phone
*
Format: (000) 000-0000.
Role in Business
*
Please Select
Member
Manager
Authorized representative
Other
Exact Registered LLC Name
*
Formation Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
State of Formation
Please Select
Indiana
Other
Not sure
Current Status
*
Please Select
Administratively dissolved
Revoked
Voluntarily dissolved
Not sure
Other
Dissolution Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Dissolution Reason
State Notices Received
*
Please Select
Yes
No
Not sure
State Notice Details
Last Business Entity Report Year
What date did you last file your takes?
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Previous Reinstatement Attempts
Principal Office Address (Primary Business Address)
*
Mailing Address
Current Member/Manager Names and Roles
*
Ownership/Management Changes
Registered Agent Name (If you don't have someone specifically designated for this role, this would be the Business Owner's name).
Registered Agent Indiana Street Address
Need Registered Agent Update
*
Please Select
Yes
No
Not sure
Outstanding Reports/Taxes/Notices Known
*
Please Select
Yes
No
Not sure
Outstanding Details
Currently Operating
*
Please Select
Yes
No
Additional Assistance and Notes
Accuracy and Authority Acknowledgment
*
I certify that the information is accurate to the best of my knowledge and that I am authorized to request assistance for this LLC.
Administrative Assistance Acknowledgment
*
I understand this is administrative assistance and not legal, tax, or accounting advice.
Eligibility and Approval Acknowledgment
*
I understand eligibility, obligations, and fees need review; approval is not guaranteed; and submitting this request does not reinstate the business.
Review and Contact Consent
*
I consent to review of this request and contact about next steps, with separate authorization required before any state filing.
Typed Name
*
Acknowledgment Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Save
Submit
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