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| First Alternative Name: | |
| Second Alternative Name: | |
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| How will the LLC be managed? |
| Please Select: | |
| Please list each of the members of the LLC. |
| Name: | |
| Street: | |
| City: | |
| State: | |
| Zip Code: | |
| Percentage/Units of Ownership: |  |
| Additional Members: | |
| If the LLC will have officers, please provide the name and title of each officer. |
| Officers & Titles: | |
| Please describe the business's primary business purpose or activity. |
| Purpose/Activity description: | |
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| If someone other than EZ Online Filing will be your Registered Agent, please enter the name and address of your Registered Agent. |
| Name: | |
| Street: | |
| City: | |
| State: | |
| Zip Code: | |
| LLC’s are required to list one member as the contact for tax matters for the IRS. Who will serve as this contact point? |
| Name: | |
| Title: | |
| SSN/EIN of this officer: | |
| Phone Number: | |
| In order for us to prepare your Federal Tax ID Form, please select one of the reasons below for applying for an EIN |
| Reason for Applying: | |
What is the final month of your accounting year? |
| Enter Date: | |
| Please enter the number of employees you anticipate in the next twelve months. If none, please enter a zero. |
| Number of Employees: | |
Do you expect your employment tax liability to be $1000 or less in a full calendar year? If you expect to pay $4,000 or less in total wages in a full calendar year, you can mark YES. |
| Please Select: | Yes
No
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| Has the applicant ever applied for and received an EIN? |
| Please Select: | Yes
No
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| If YES, provide the previous EIN here: | |
Does your business own a vehicle with a taxable gross weight of 55,000 pounds or more? Only include vehicles that were designed to carry loads on the highway. |
| Please Select: | Yes
No
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Will your business operate a casino, or does your business involve gambling or wagering? |
| Please Select: | Yes
No
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Does your business need to file form 720 (Quarterly Excise tax Return)? Please note: this is not common. |
| Please Select: | Yes
No
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Does your business make or sell alcohol, tobacco or firearms? |
| Please Select: | Yes
No
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