Sell Company

Name of Entity:

Your Asking Price; or Best Offer:

Date Formed or Organized:

State Formed or Organized:

Is your Entity in good standing in the state in which it was formed or organized? (Yes/No)

Yes

The entity is a:

Sub Chapter S Corporation

Dual Class LLC

Not For Profit Corporation

For Profit Corporation

Not For Profit Corporation with a Favorable IRS Letter of Determination

Limited Partnership

Limited Liability Partnership

Single Member LLC

Single Member LLC taxes as a corporation with favorable IRS Letter of Determination

Multi Member LLC

C Corporation

Professional Corporation

Professional LLC

Other:

Does your entity have:

Dun and Bradsheet number:

Federal Tax Identification Number or other Country Number:

State Sales Tax Number:

Worker's Compensation Insurance Experience and Nodification rating:

Bank Account: (Yes/No)

Yes

Checking Account: (Yes/No)

Yes

Money Market Account: (Yes/No)

Yes

Bank Line of Credit:

Bank Line of Credit Additional details:

PROVIDE CONTACT CHANNEL FOR BUYERS - You decide which or all contact channels:

Name:

Phone Number:

Email Address:

BILLING INFORMATION:

Name on Card:

Billing Information:

City:

State:

Zip:

Select a Payment Option:

Note: We will begin processing your order once payment is received.

Payment by Credit Card:

Billing Address:

Other Information:

Where did you hear about Companies Incorporated?:

Have you previously spoken with an incorporation specialist over the phone?

Yes No

Note: We will begin processing your order once payment is received.

Payment by Credit Card:

Billing Address:

Other Information:

Where did you hear about Companies Incorporated?:

Have you previously spoken with an incorporation specialist over the phone?

Yes No

Note: We will begin processing your order once payment is received.

Payment by Credit Card:

Billing Address:

Other Information:

Where did you hear about Companies Incorporated?:

Have you previously spoken with an incorporation specialist over the phone?

Yes No

Note: We will begin processing your order once payment is received.

Payment by Credit Card:

Billing Address:

Other Information:

Where did you hear about Companies Incorporated?:

Have you previously spoken with an incorporation specialist over the phone?

Yes No

Note: We will begin processing your order once payment is received.

Payment by Electronic Check:

Other Information:

Where did you hear about Companies Incorporated?:

Have you previously spoken with an incorporation specialist over the phone?

Yes No

Note: We will begin processing your order once payment is received.

Other Information:

Where did you hear about Companies Incorporated?:

Have you previously spoken with an incorporation specialist over the phone?

Yes No

Note: We will begin processing your order once payment is received.

Other Information:

Where did you hear about Companies Incorporated?:

Have you previously spoken with an incorporation specialist over the phone?

Yes No

Note: We will begin processing your order once payment is received.

Other Information:

Where did you hear about Companies Incorporated?:

Have you previously spoken with an incorporation specialist over the phone?

Yes No