Application for a Corporation - Seton & Associates

1) In what state will you be forming your new organization?

State

2) Company Name

a) The name of your organization will be:*

b) If your first choice is unavailable, an alternative name will be:

3) Business Purpose

4) Shares of Common Stock

Usually between 0 - 10,000 shares

5) Contact Information

This is the sole authorized contact that we will communicate with throughout the application process.

Contact*

Title

Phone*

Fax

Email*

6) Principal Place of Business

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

7) Resident Agent

This is a person who will accept legal service of process; must be a real person residing in your state of registration; cannot be a P.O. Box

Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

8) Directors

The IRS generally requires a minimum of at least three (3) directors. If you need additional space to list more Directors, please list them on a separate attachment.

Name 1

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Compensation

Name 2

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Compensation

Name 3

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Compensation

9) Officers

CEO (President)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Compensation

COO (Secretary)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Compensation

CFO (Treasurer)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Compensation

Vice President (if applicable)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Compensation

Other Officer (if applicable)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Compensation

Other Officer 2(if applicable)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Compensation

10) Shareholders

All sensitive data filled out on this form will be encrypted.

Name of Shareholder

SS#

Number of Shares

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Email

Name of Spouse

SS#

Name of Shareholder

SS#

Number of Shares

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Email

Name of Spouse

SS#

Name of Shareholder

SS#

Number of Shares

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Email

Name of Spouse

SS#

Name of Shareholder

SS#

Number of Shares

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Email

Name of Spouse

SS#

11) Employer Identification Number

As part of our formation package, a Form SS-4 will be filed for your new entity. The Form SS-4 is what gives your organization an Employer Identification Number (EIN). To assist us in filing the Form SS-4, please provide the information requested below. All sensitive data filled out on this form will be encrypted.

Principal Officer

Social Security Number

Date Organization Started

Closing Month of Accounting Year

First Date Wages Will Be Paid

Highest # of employees expected in the next 12 mos.

Is the Principal Business Activity manufacturing a good?

To whom are most of your products/services sold?

Principal Activity

What will you be selling? (Services, goods, or N/A)

Have you ever applied for EIN before?

Yes
No

If yes, when?

In what State and City?

EIN Number

Will you engage in gambling/wagering?

Yes
No

Will you sell fire arms?

Yes
No

Will you sell tobacco?

Yes
No

Do you expect your employment tax liability to be $1,000 or less in a full calendar year?

Yes
No

12) Billing & Mailing Information

Billing Information

Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Fax

Email

Mailing Information

To use Billing Information above

Check here

Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Fax

Email

13) Payment Information

All sensitive data filled out on this form will be encrypted.

Card Type

Visa
Mastercard

Name of Cardholder

Credit Card Number

Expiration

3 Digit V-Code