Business Registration Questionnaire

Please complete the questionnaire below:

1. 
   Name of the Business:
   

2. Principal Business Address:

3. Name(s) and preferred title(s) of the owner(s) – for e.g.: Member, CEO, President etc.

4. Address of the Owner(s):

5. 
   Business email:
   

6. 
   Preferred effective date:
   

7. What type(s) of operating activity will the business perform?

8. Name and telephone of the responsible person

9. Social Security Number of the responsible person:

10. Name and Address of the Registered Agent:

Note: JES Accounting Partners charges an annual fee of $75 to act as your Registered Agent.