Corporation Data Sheet – MLS Business Solutions

Employer Id

Date Incorporated

NACIS Code

Number Of Employees?

Name of Business

Doing Business As (DBA)

Corporation EIN

Business Address

Suite, etc

City

State/Province

ZIP / Postal Code

Contact Person Name

Business Phone

Email Address

Principle Business Activity

State Of Incorporation

Incorporation Number

Date of election as "S" Corp

EDD Account #

BOE Account #

BOE Express Login

Bank Name

Routing Number

Account Number

Members Information

Member 1

Member 1 Name

Member 1 SSN

Member 1 Title

Mem. 1 % of Ownership

Member 2

Member 2 Name

Member 2 SSN

Member 2 Title

Member 2 % of Ownership

Member 3

Member 3 Name

Member 3 SSN

Member 3 Title

Member 3 % of Ownership

Member 4

Member 4 Name

Member 4 SSN

Member 4 Title

Member 4 % of Ownership

Member 5

Member 5 Name

Member 5 SSN

Member 5 Title

Member 5 % of Ownership

Registered Agent

Agent Name

Agent Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Agent Phone

Agent Email Address

Additional Information and Comments

Please select box.

The above is true, correct and to the best of my knowledge.

Your Full Name

Date of Birth

Today's Date

Color copy of DL Front & Back

Copy of incorporation papers

Copy of Tax ID ( SS-4 Form)

Feb. 2020 Bank Statement

Business Type