Business Questionnaire
We will use the information provided on this questionnaire to form your business entity.  Please be sure to type all information as you would like it to appear.  If you have any questions, please feel free to give us a call at 706-662-8881 or email us at contactus@hillardcpa.com
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Email *
Full Name (First, Last) *
Contact Number *
Full Mailing Address *
Enter your full mailing address to include city, state, and zip code
Entity Type *
Desired Business Name: *
Please enter your desired business name exactly as you would like it to appear on your formation documents.  Please note:  If you are forming an LLC, the letters "LLC" must be used in the name.  
Alternate Business Name: *
Please enter an alternate business name In the event your desired business name is not available.
Business Physical Address: *
Enter the full mailing address including the city, state, and zip code.
State *
Please list the state in which the business is to be formed.  
County *
Please list the county in which the business will be located.
Business Category *
Business Description *
Add a simple description of your business's activity.
Registered Agent Information *
A registered agent is a person or company officially recognized by the state that resides in the state of incorporation and is designated by the corporation to accept service of process on behalf of the corporation.
Company Management *
Member Information *
List the name of each member, their address, and their ownership percentage.  For example, Jane Doe, 2221 W South Street, Somewhere, Happy 31000, 100%.  
Tax Contact Information *
Designated contact for tax purposes.  Please list the contact's name, title (President, Owner, etc.), and SSN.  For example, Jane Doe, President, 999-99-9999.
Payment Acknowledgement: *
By checking the box, you acknowledge that the initial fee of $300 does not include any state fees and that such fees will be billed to you before any work is completed.  You understand that Hillard Tax & Accounting will send an invoice for any state fees once such fees have been determined based on the state of registration.
Required
Authorization: Type Your Name *
With my digital signature, (i) I represent and warrant that all of the information provided above is accurate and complete; (ii) I agree that I have carefully read and agree to be bound by the Terms of Use and Privacy Policy (provided below) and (iii) I have read and understand that I am hereby authorizing HT&A  as a "Third Party Designee" as described in the instructions to Form SS-4 to apply to the IRS for the Employer Identification Number of the person or entity listed above, answer any questions on my behalf or the behalf of the entity listed above about the completion of Form SS-4, and to receive and deliver to me the Employer Identification Number for me or the entity listed above.  HT&A acts as a “Third Party Designee” as described in the instructions to Form SS-4 to help clients obtain Federal Tax ID Numbers from the Internal Revenue Service (the “IRS”) in a timely manner. HT&A only works on behalf of its clients and is in no way affiliated with any governmental or regulatory agency, including the IRS. HT&A offers a paid service in which its employees or agents will prepare and submit your Employer Identification Number Application (“EIN Application”) to the IRS on your behalf. Alternatively, for no charge, you can visit the official IRS.gov website and complete your EIN Application on your own. HT&A does not review the information submitted on your EIN Application. We are not a law firm or a substitute for an attorney or law firm. We cannot provide any kind of advice, explanation, opinion or recommendation about legal issues, and our communications are not protected by the attorney-client privilege or as work product. For legal advice, please contact an attorney or law firm.  Our paid service will process your application for an EIN/Tax ID number (SS-4 Form) with the IRS to obtain your Tax ID Number and deliver it to you quickly and securely via email. The IRS does not supply Tax ID Numbers via e-mail. Our EIN form is simplified for your ease of use, accuracy, and understanding, saving you time! We guarantee you will receive your EIN within 1-2 business days, but many applications are processed and EINs are delivered to you same day, within hours.
A copy of your responses will be emailed to the address you provided.
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