Filing Form Page – NUCO Filings

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FIRST NAME *

LAST NAME *

EMAIL *

PHONE *

TYPE OF ENTITY

STATE OF FORMATION

TYPE OF SERVICE REQUESTING

NAME OF ENTITY

MESSAGE

Form date

Renewal Date

State of Original Formation

Principal Office Address

Address Line 1

Address Line 2

City

State

Zip Code

Who is Registered Agent

RSA
Other

RA Renewal date

RA Name

First

Last

RA Address

Address Line 1

Address Line 2

City

State

Zip Code

RA Phone

RA Email

RA SSN

Notified RA?

Yes
No

Member or Manager

Member
Manager

Shares

Shares

Number of Shares

par value of shares

General Partners Name

First

Last

General Partners Address

Address Line 1

Address Line 2

City

State

Zip Code

Parent/Client Name

First

Last

P/C Address

Address Line 1

Address Line 2

City

State

Zip Code

P/C Phone

P/C Company/Account

P/C Email

P/C Other Contact

Signers - Organizer

Signers - Incorporator

Signers - Authorized Signer

First

Last

Authorized Signer Title

Signers - Address

Address Line 1

Address Line 2

City

State

Zip Code

File number/BID

EIN Responsible Party

check if different than user or client

EIN RP - Name

First

Last

EIN RP - Business Address

Address Line 1

Address Line 2

City

State

Zip Code

EIN RP - Mailing Address (if different)

Address Line 1

Address Line 2

City

State

Zip Code

EIN RP - Phone

EIN RP - Email

EIN RP - SSN

Purpose

Number of Members

Publication Requuired?

Yes
No

Publication County

Publication 1 - Name

Publication 1 - Cost

Publication 1 - End Date

Publication 1 - Affidavit

Publication 2 - Name

Publication 2 - End Date

Publication 2 - Cost

Publication 2 - Affidavit

Publication - COP File Date

Publication - COA File Date

DBA - Name

DBA Form Date

DBA Renewal Date

DBA Address Being USED

Address Line 1

Address Line 2

City

State

Zip Code

Dissolution Date

Notes

Our cost

Service Fee

RSA File

Invoiced

Yes
No

Paid

Full
Other Amount

Other Amount

Order Contact - Name

First

Last

Order Contact - Email

Internal Sales Rep