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CORPORATE ACCOUNTS
FORM AN LLC

Account Information

Account / Firm Name:

Order Placed By:

Reference # (optional):

General Information

State of Formation:

Entity Name:

(Please list two options to ensure availability)

List names exactly as they should appear,
including name ending (i.e. LLC)

Agent Information (Not necessary for NY state)

Registered Agent Name:

Street Address:

I have no agent. Please provide a registered agent for this entity.

Entity Address

Mailing Address:

County:

Member Information (optional)

Member Name:

Member Title:

Member Address:

Corporate Supplies (optional)

Kit and Seal
Seal

Corporation Information (optional)

Please provide a Tax ID number for this entity

Name of Manager or Managing Member:

Social Security Number:

Principal Business Activity:

Business Type:

Multi Member / Partnership
Single Member LLC

Publication (optional)
A New York LLC is required to be published.
Publication should begin with 120 days of the date of formation.

Please publish this LLC upon its formation.

Publication County:

Special Instructions

Please include any special instructions in this text area.

Questions About this Order

An incorporation specialist will review your order
and contact you, if necessary, at:

ext.

A detailed order confirmation will be sent to you @:

To speak with a live representative about this order please call 845-425-0077.

Carefully review the information entered then click submit.

"Our experience with incorporating our company was flawless and pleasant"

Thanks,
Jaime Frand - N.J.

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