LLC/CORPORATION FORMATION QUESTIONNAIRE

Completion of this form to the best of your ability prior to your initial meeting will better prepare your attorney to efficiently address your specific needs. You may not know the answers to many of the questions below, and some questions will not apply to your circumstances. This document will serve as an outline for discussion in your initial meeting with a Rudman Winchell attorney and for the attorney to prepare your LLC agreement or corporation bylaws.

Please indicate the primary purpose for wanting to form a business entity:

If “Acquiring” is checked, please indicate if the acquisition is of:

If other please describe:

Please briefly describe your business.

Do you know what type of entity you want to form?

If “Yes” is checked, please select one of the following:

If Other please describe.

What is the proposed name of your entity?

If your first choice of name is unavailable, what is an alternate name choice?

Type of business and/or principal activity of the entity:

Please provide contact information for the new entity/business:

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Area CodePhone Number

Email

example@example.com

Fax

If a P.O. Box is to be used as the address, please providean alternate address that includes a street address:

Have you registered any website domain names in anticipation of launching the business?

If “Yes” is checked, please list the URLs

Would you like for us to serve as your Registered Agent/Clerk?

If “No” is checked, please provide the name and address of the Registered Agent/Clerk you would like to use (please provide a physical street address):

For each initial equity owner (e.g. initial investor), please list the name(s) of partners

Does the business have an accountant?

If “Yes” is checked, please provide the name and contact information of the accountant:

If “No” is checked, would you like Rudman Winchell to provide a referral?

Have you considered your business insurance needs (Casualty, Commercial General Liability, Accounts Receivable Insurance)?

"If Yes" Please provide the name and contact information of the insurance broker.

If “No” is checked, would you like Rudman Winchell to provide a referral?

Would you like Rudman Winchell to provide a referral?

Are there other referrals you would like to receive for the business (e.g., bankers, payroll companies, estate planning attorneys, financial advisors, etc.)?

If “Yes,” please list the referrals the business would like to receive:

Please indicate how you were referred to Rudman Winchell.

If you were referred by a current client/other please indicate here.

Please verify that you are human