Nonprofit Corporation Information Form

Incorporation

State of Formation:

Name (1st Choice):

Name (2nd Choice):

Name (3rd Choice):

Will the Non-Profit be formed for Charitable, Public, or Charitable and Public use?

Will the company be filing for tax-exempt status using the 501(c)(3) IRS code?

If other IRS code please list:

Company Information

Contact Name:

Contact Address:

Contact City, State, and Zip Code:

Contact Email:

Contact Phone Number:

Legal Information

Company's Legal Address:

City, State, & Zip Code:

Billing Address:

City, State, & Zip Code:

Company Directors (Typically states will require a minimum of 3 Directors for filing):

Director Name:

Director Address:

Director Name:

Director Address:

Director Name:

Director Address:

Company Officers:

President:

Vice-President:

Secretary:

Treasurer:

Would you like for us to obtain the EIN?

If so, please list the name and social security number for one of the Directors:

Name:

Social Security Number:

State Specific Information

Will you be operating your business in more than one state? Yes No

If yes, what other states? (Hold Ctrl key to select multiple)

Any Questions or Comments?

If so, enter them here:

Are you a real person?

Enter the letters you see in the box. If you can't make them out, click on the "arrow circle" to refresh the image.