First Name
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Last Name
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Full legal name of your company
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What type of company is it?
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LLC
Corporation
Company Street Address
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Suite or Unit Number
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City
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Zip code
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Your Telephone Number
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Email
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Check all of the following that apply
Has this company granted any stock options, warrants, convertible debt or SAFE's?
Does this company have an employee stock option plan?
Is any owner another entity? A corporation, LLC or a trust
What's your company's EIN (Employer Identification Number)?
In what state was your company formed?
Was your company formed before January 1, 2024?
If your company already has a FINCEN ID, what is it? (probably not - and if not, leave blank)
Please attach a copy of your ID (driver's license or passport) and the ID of EACH person who owns or controls 25% or more of the company AND any officer, director, or managing member.
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If your or their address is not on their ID (addresses are not on passports), please list their names and addresses here
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