Business Formation Questionnaire

"*" indicates required fields

Managing Member*

First Name Last Name

Percentage of Ownership*

Is there a Secondary Member (yes) or (no) if no then skip “Spouse name” and Enter N/A If Yes then Enter Name (First, Middle and Last)*

Yes

Secondary Member or N/A **

Percentage of Ownership

List at least 3 potential company names:*

Company Physical Address*

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

Is there a separate mailing address? (yes) or (no) if no then skip “mailing address” If Yes then Company Mailing Address

Yes

Separate Mailing Address*

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

Company Industry*

Manager (First and Last Name)*

Additional Manager (First and Last Name) or N/A*

Trust Name (if applicable)

Phone*

Email*

4247

Rockwall Office