Incorporation Intake Form

Section 1: Client Information

Full Legal Name

First Name:
Middle Name:
Last Name:

Date of Birth:

Phone Number:

Email Address:

Mailing Address:

City:
State:
Zip:

Preferred Contact Method:
EmailPhonePortal

Section 2: Company Information

Proposed Business Name (1st Choice):

Alternative Names:

Business Purpose / Industry:

Products/Services Offered:

Website (if available):

State of Incorporation/Formation:

Preferred Incorporation Date:

Duration of Company:
PerpetualSpecific Term

Section 3: Entity Type

Limited Liability Company (LLC)Corporation–C-CorpCorporation–S-CorpProfessional Corporation (PC/PLLC)Partnership (General/Limited/LLP)Nonprofit Organization

Section 4: Ownership & Management

Number of Owners/Members:

Owner(s)/Shareholder(s) Information

Owner/Shareholder 1: Name % Ownership Address

Owner/Shareholder 2: Name % Ownership Address

Attach sheet if needed (max 5MB, only .xls or .xlsx):

Management Structure:
Member-Managed (LLC)Manager-Managed (LLC)Board of Directors (Corporation)

Section 5: Registered Agent

Do you require BizProz Registered Agent Services?
Yes, appoint BizProz as my registered agent.No, I already have a registered agent.

Section 6: Tax & Compliance

Do you need a Federal EIN/Tax ID?
Yes – apply on my behalfNo – I already have one

Do you want S-Corp election (if eligible)?
YesNo

State/Local Tax Registrations Needed (sales tax, payroll, etc.):
Yes – please assistNo

Do you require Compliance Services (annual reports, deadlines, reminders)?
YesNo

Section 7: Business Licenses & Permits

Do you need assistance obtaining business licenses/permits?
Yes – FederalYes – StateYes – LocalNo

Section 8: Additional Services (check all that apply)

Virtual Business AddressMail Forwarding ServiceTrademark RegistrationCopyright RegistrationBusiness License AssistanceDocument Filing & RetrievalOperating Agreement/Bylaws DraftingCorporate Kit(seal, stock certificates, binder)Subscription Plan (Starter/Growth/Enterprise)

Section 9: Banking & Finance (Optional)

Do you require help setting up a business bank account?
YesNo

Would you like assistance with:
Merchant Services (credit card processing)Accounting/Bookkeeping SetupPayroll Setup

Section 10: Communication Preferences

EmailPhoneClient PortalText/SMS

Section 11: Authorization

I hereby authorize BizProz to prepare and file the necessary documents to incorporate my business in accordance with the information provided above. I confirm that all information is accurate to the best of my knowledge.

Signature:

Date: