Business Intake Form

1

What type of business would you like to form?

Corporation

Limited Liability Company (LLC)

2

Your business name must meet California requirements and be distinguishable from existing businesses.

Corporations: Words or abbreviations such as Inc., Incorporated, Corp., Corporation, Co., or Ltd. may be added to the end of your business name, but are generally optional.

LLCs: Your business name must end with LLC, L.L.C., or Limited Liability Company.

All business names are subject to final approval by the California Secretary of State.

3

Preferred Business Name (1st Choice)* This field is required.Enter the business name you would like to register with the California Secretary of State.

4

Alternate Business Name (2nd Choice)If your first choice is unavailable, we will attempt to register this name.

5

Business Address* This field is required.This address will be used for California Secretary of State filings.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

6

Is your mailing address different from your business address?* This field is required.

Same as business address

Different address

7

Mailing Address* This field is required.Enter the mailing address for official correspondence.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

8

Business Phone Number* This field is required.This number is required for IRS filings and may be a personal phone number.

9

Primary Contact Email* This field is required.This may be a personal email address.

10

How many shareholders/owners will the business have?* This field is required.Include anyone with an ownership interest in the business.

1

2

11

First Shareholder/Owner – Legal Name* This field is required.Enter the full legal name as it appears on government-issued identification

First Name

Last Name

12

Is the first shareholder/owner’s address different from the business address?* This field is required.

Same as business address

Different address

13

First Shareholder/Owner – Mailing Address* This field is required.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

14

First Shareholder/Owner – Ownership Percentage* This field is required.Enter a number between 0 and 100

15

Second Shareholder/Owner – Legal Name* This field is required.Enter the full legal name as it appears on government-issued identification

First Name

Last Name

16

Is the second shareholder/owner’s address different from the business address?* This field is required.

Same as business address

Different address

17

Second Shareholder/Owner – Mailing Address* This field is required.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

18

Second Shareholder/Owner – Ownership Percentage* This field is required.Enter a number between 0 and 100

19

Nature of the Business* This field is required.Briefly describe what the business will do.

20

Intake Consent Form* This field is required.

Yes — I authorize Empresa Solutions to prepare and submit my business formation and related filings based on the information provided.