OHANESON & EASH, P.C.

114 South Main Street
Middlebury, IN 46540

(574) 825-9665

Please fill in the information below to the best of your ability. Thank you.

Contact information: Owner Name

Prefix

First name *

Middle name

Last name *

Date of birth

Emails

Email Address *

Type

Upon submission, a copy of this form will be sent to the primary email.

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Addresses

Street address

Country

City

State/Region

Province/Region

Zip/Postal code

Address type

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Phone numbers

Phone number

Type

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Add phone number

Do you know the type of business you would like to start?

Yes

No

Are you starting a Sole Proprietorship or General Partnership?

Yes

No

What type of income structure will your business have?

Select your business type from the list below:

Please list your top choices for the name of the business.

What e-mail address do you want to use for correspondence from the State of Indiana?

What address should we use for the business? (The State of Indiana will send correspondence to this address.)

Do you want this business to become effective as of the earliest date possible?

Yes

No

What date do you want the business to officially begin?

What is your social security number?