All States-Non Profit Basic Incorporation Service

All States

ONLINE WORKSHEET FOR ORGANIZING A NON-PROFIT CORPORATION

Please furnish us with the following information to organize a Non-Profit Corporation.

Contact Information

Firm Name

Attention

Phone

Address

Street Address City State ZIP Code

Entity Information

State to Incorporate In

Proposed Name

2nd Choice

3rd Choice

Brief Statement of Purpose

Fiscal Year Ending (Last Day of)

Will the corporation have members?

Will the corporation apply for recognition under section 501(C)(3) of the Internal Revenue Code?**

Principal Business Address

Street Address Address Line 2 City State ZIP Code

Business Email

Business Phone

Incorporator Name and Address

Incorporator

M. Burr Keim Company to sign as incorporator

Incorporator Name

Incorporator Address

Street Address Address Line 2 City State ZIP Code

Registered Agent Information

Registered Agent

M. Burr Keim Company to Provide

We can provide the required registered office service. Our annual fee for most states is $125.

Registered Agent Name

Registered Office Address

Street Address Address Line 2 City State ZIP Code

P.O. Box is not accepted. The address must be in the state of formation with the exception of New York which permits any mailing address in the U.S.A.

Registered Agent Email

Registered Agent Phone

Officer & Director Information

Officer Name

Officer Title

Director

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Officer Name

Officer Title

Director

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Officer Name

Officer Title

Director

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Officer Name

Officer Title

Director

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Federal Employer Identification Number (FEIN)

Please complete the following section if you would like M. BURR KEIM COMPANY to obtain the FEIN.

FEIN - Legal name of the responsible person

Social Security Number

FEIN - Mailing Address

Street Address City State ZIP Code

FEIN - Phone

Does the entity have/expect to have employees who will receive forms W-2 in the next 12 months?

Yes

Does the entity expect to pay less than $5,000 in total wages during the next calendar year?

Yes

When does the entity expect to begin paying wages (mm/yr)?

**After the corporation has been organized it is necessary to obtain recognition from the IRS of nonprofit status. This is done by filing an application for recognition as a nonprofit entity. If the corporation has been organized for charitable, educational, scientific or literary purpose form 1023 must be filed with the IRS (religious entities are not required to but many may apply for recognition).

All other nonprofit corporations must file form 1024.

Call IRS at 1-800-829-3676 to obtain the appropriate forms and publication 557 which more fully describes the filing requirements. Forms may also be obtained at https://www.irs.gov/

Pricing Information

Estimated Cost

Please email estimated costs before proceeding with this request

Estimated costs vary by state. If you would like our office to email estimated costs to you prior to proceeding with your request, please check this.

Membership Certificates

Please include membership certificates with my corporation outfit - add $19.75.

Special Instructions

If additional information is required by your state for incorporation, we will reach out to you by email and/or phone to proceed.

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