INFORMATION NEEDED TO FILE YOUR COMPANY’S BOIR

Please email the completed form to boifilerllc@gmail.com. If any questions call (269) 355-6054.

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A. For each Beneficial Owner needs the following information to file

1. Name
2. Date of birth
3. Address, and
4. The identifying number and issuer from either a non-expired U.S. driver’s license, a non-expired U.S. passport, or a non-expired identification document issued by a State (including a U.S. territory or possession), local government, or Indian tribe. If none of those documents exist, a non-expired foreign passport can be used. An image of the document must also be submitted.

Beneficial Owner #1

Name:

Date of Birth:

Address:

Street address::

City:

Zip Code:

Driver’s License or number, with your picture: (Must be current.)

State of Issue:

Attached a PDF file or photo of your Driver’s License or State Identification Card:

Beneficial Owner #2

Name:

Date of Birth:

Address:

Street address::

City:

Zip Code:

Driver’s License or number, with your picture: (Must be current.)

State of Issue:

Attached a PDF file or photo of your Driver’s License or State Identification Card:

Beneficial Owner #3

Name:

Date of Birth:

Address:

Street address::

City:

Zip Code:

Driver’s License or number, with your picture: (Must be current.)

State of Issue:

Attached a PDF file or photo of your Driver’s License or State Identification Card:

Beneficial Owner #4

Name:

Date of Birth:

Address:

Street address::

City:

Zip Code:

Driver’s License or number, with your picture: (Must be current.)

State of Issue:

Attached a PDF file or photo of your Driver’s License or State Identification Card:

B. Each Company must supply:

1. Name
2. EIN
3. Address
4. If formed after January 1, 2024, the information required in A, about the (“company applicants” who is the person who submitted to formation information to the state where the business was form (“Submitter”) and the person from the business that supplied the formation information to the Submitter.

Company Information:

Name

Street Address

City

State

Zip Code

EIN Number a copy of the IRS letter with the number can be attached.

A. If the company was formed on or after January 1, 2024, then supply the following: i. Person at company who hired the person who filed the formation documents with the state: :

Name

Date of Birth:

Address:

Street Address

City

State

Zip Code

Driver’s License or number, with your picture: (Must be current.)

State of Issue:

Attached a PDF file or photo of your Driver’s License or State Identification Card:

i. Person who actually filed the company formation documents with the state:

Name

Street Address

City

State

Zip Code

EIN Number a copy of the IRS letter with the number can be attached.

Date the company was formed:

Please email the completed form to boifilerllc@gmail.com. If any questions call (269) 355-6054.

Where to find us

Email

boifilerllc@gmail.com

Phone

(2690) 355-6054

Office

BOI Filer LLC
360 E. Allegan Street, Suite C Otsego, MI 49078
(269) 355-6054