Attorney General Registration: 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*
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Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Organization Information
Organization Name*
Please enter the full legal organization name including punctuation and the entity suffix (LLC, Inc., etc.)
Organization DBA ("Assumed Name")
The name the organization goes by other than its legal name, if applicable.
State of Incorporation / Organization*
Organization Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Organization Phone Number*
Organization Fax Number
Organization Email Address*
Organization Website
Organization EIN
Federal tax ID number. An EIN must be obtained before the business may obtain a county business license. If an EIN has not yet been obtained, our firm can obtain an EIN for your business for $100.
Organization Directors and Officers*
There must be at least 3 directors.
Please list each person's address and title in the business next to their name.
Date Organization Started*
Approximate date the business started or will start.
Date Format: MM slash DD slash YYYY
Organization Activities*
General description of what the business does, or which industry it is in.
Other Businesses Owned*
Please include the full legal business name(s) - including punctuation and the entity suffix (LLC, Inc., etc.) - of the other business(es) you own.
Annual Accounting Period / Tax Year*
- Calendar Year
- Fiscal Year
Fiscal Year End Date*
Your company's fiscal year ends on what month and day?
Responsible Party*
The responsible party controls, manages, or directs the applicant entity and the disposition of its funds and assets. The IRS describes it in greater detail here: https://www.irs.gov/Businesses/Small-Businesses-&-Self-Employed/Responsible-Parties-and-Nominees
The responsible party may be an individual, in which case we will need the individual’s full name and social security number. We will not use the responsible party's social security number for any other purpose and will keep it strictly confidential. The responsible party may be another business entity, in which case we will need the business’ name and EIN.
Responsible Party Tax ID*
The responsible party's SSN or EIN.
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.
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Organization Information