My Business

Business Identification

Legal Name: Legal name of entity

Trade Name: Trade name/DBA

Business Structure: Type of entity/business structure

State of Incorporation: State of incorporation/organization

Business Start Date: Date business started or acquired

Contact Information

Street Address: Street address of principal place of business

County and State: County and state of principal business

City, State, ZIP: City, state, and ZIP code

Personnel Information

Responsible Party: Responsible party name

Tax Registration

Accounting Year: Closing month of accounting year

Employment Info: Employment information