Trade Name Only Business License

Business name and address
Business name*
Primary business location (does not have to be DE)*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Mailing address if different from primary business location
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Tax contact information
First and last name of tax contact*
First name Last name
Phone number*
Email*
Fax (optional)
Authorized person*
First name Last name
Business information
FEIN or SSN/ITIN*
This number is a*
- FEIN
- SSN or ITIN
What type of entity is the business?*
When was this business incorporated?*
When was this business incorporated?*
When was this business incorporated?*
Does this business have shareholders that DO NOT reside in Delaware?*
- Yes
- No
What type of Limited Liability Company?*
Please provide sole proprietor first and last name*
First Last
Please provide sole proprietor date of birth*
Is this business's annual gross receipts less than $10,000?*
- Yes
- No
What type of entity is this business?*
Please make a selection.*
Please describe.*
Please provide sole proprietor first and last name*
First Last
Please provide sole proprietor date of birth*
Is this business's annual gross receipts less than $10,000?*
- Yes
- No
Unique ID

Contact Information

Please provide contact information for the point of contact for this order.
Are you an existing Incserv client?*
- Yes
- No
Enter Client ID or Client Name*
First and Last Name*
Phone*
Email Address*
Contact Information*
Billing Information*
*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country