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Please complete the requested information below for your Employer Identification Number.
Infotax Square representative will begin processing your order upon receipt of payment.
PLEASE SELECT
Type of Entity:
State:
CONTACT INFORMATION (This is where we will ship your documents)
First Name:
__________________________________
Last Name:
__________________________________
Address:
__________________________________Suite/Apt:_____________________
City, State, Zip:
_______________________________________________________________
Telephone Number:
(________)____________________________-_________________________
Fax Number (if any):
(________)____________________________-_________________________
BUSINESS OVERVIEW
Name of Entity:
_______________________________________________________________
Owner/Officer Name & Title:
_______________________________________________________________
Social Security Number:
_________________________________________ (999-99-9999
)
State of Formation:
Date of Formation:
________________________(mm/dd/yyyy)
Address:
_______________________________________________________________
Suite/Apt:
_______________________________________________________________
City, State, Zip:
_______________________________________________________________
Selected Tax Year:
_______________________________________________________________
Business Description:
_______________________________________________________________
_______________________________________________________________
Reason for Applying:
Starting New Business
Changed Type of Business
Purchased Going Business
Compliance with IRS withholding regulations Created a pension plan
Have you ever applied for EIN for this or any other business? Yes No
Employer Identificationh Number (EIN)
TEL:
1-866-754-4460
718.732.2471
FAX:
2
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