Foreign Entity Qualification: Intake Form

Please submit the following information via this online form, which is encrypted with SSL to help ensure the data you enter is secure.

Name*
Prefix First Middle Last Suffix
Email*
Enter Email Confirm Email
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Business Information
Business Name*
Please include the full legal business name including punctuation and the entity suffix (LLC, Inc., etc.)
Business DBA ("Assumed Name")
The name the business goes by other than its legal name, if applicable.
Business Address (Principal Office)*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Business Owners and Officers*
Please list each person's title in the business next to their name.
State of Incorporation/Organization*
Date of Incorporation/Organization*
Date the business was formed in it's home state.
MM
DD
YYYY
Status of Registered Agent*
- The business has a registered agent in Kentucky.
- The business needs your firm to serve as registered agent in Kentucky.
Registered Agent Name*
Registered Agent Address*
Street Address Address Line 2 City State ZIP Code
Additional Information
Please include any additional information you would like our attorneys to know.
Disclaimer*
Our attorneys may review the information you submit for the purposes described on this website. The use of this form for communication with our firm does not establish an attorney-client relationship. Our review of the information sent to us will not preclude us from representing any other client if confidential information is sent through this form.
- I agree
- I do not agree
Phone
This field is for validation purposes and should be left unchanged.

Save and Continue Later

Foreign Entity Qualification: Intake Form

Business Information