Registration

Business Registration Application
Applicant Information

Client Questionnaire
Legal Name Applicant

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Overview
Proposed legal business name
Alternate business name(s), if primary is unavailable
Enter 2 additional names
Business address (physical location, if different from mailing)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County of Operation
Start Date

MonthDayYear
Date you would like the business to be active
Brief description of business activities/services
Business Structure

If LLC or Corporation is selected: Number of owners/members/shareholders Ownership percentage for each will be needed.
Desired business entity type:

Other
Will the business have a registered agent in Florida
Ownership & Compliance
Full legal name(s) of all owners/officers/Shareholder/Agent

First NameLast Name
Percentage of Ownership
1%-100% All must equal to 100%
Title
Full legal name(s) of all owners/officers/Shareholder/Agent

First NameLast Name
Percentage of Ownership
1%-100% All must equal to 100%
Title
Full legal name(s) of all owners/officers/Shareholder/Agent

First NameLast Name
Percentage of Ownership
1%-100% All must equal to 100%
Title
Tax & Licensing
Will the business have employees within the next 12 months?
Do you expect to collect sales tax?
Will the business require any of the following? (check all that apply)
Estimated monthly or annual revenue (if known)
Banking & Accounting Setup
Will you be opening a business bank account?
Do you need assistance or are you interested in additional setups?
Any deadlines or special circumstances we should be aware of?
If applies, please enter date and details
Additional Notes or questions
Government-Issued Picture Identification
Government-Issued Picture Identification

If picture is not an option
Cancelof
I hereby certify that all information provided in this application is true, correct, and complete to the best of my knowledge and belief. I understand that I am solely responsible for the accuracy of the information supplied and for any consequences arising from false or incomplete statements. I understand that any false, misleading, or omitted information may result in delays, denial, or other consequences under applicable law.

I understand that knowingly providing false or inaccurate information may subject me to civil or criminal penalties.

I understand that the accountant is relying on this information as provided and is not responsible for inaccuracies supplied by me.
Date

MonthDayYear
Date
Print name
Signature
Should be Empty:

Business Registration Application

Applicant Information

Business Overview

Business Structure

Ownership & Compliance

Tax & Licensing

Banking & Accounting Setup