Business Registration Form

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USI LOGISTICS SOLUTIONS

A Business and Logistics Services Company

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Personal Information

First Name

Last Name

Email

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Phone

Business Information

Type of Business Registration

Sole Proprietorship

Partnership

LLC

PLLC

S-Corp Election

C-Corp Registration

S-Corp Registration

Professional Corporation

Nonprofit

Name of Company

Business Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Please provide name,title, and % of ownership

Thanks for submitting!

Business Registration Form

Personal Information

First Name

Last Name

Email

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Phone

Business Information

Type of Business Registration/Formation

Sole Proprietorship

Partnership

LLC

S-Corp Election with IRS

C-Corp

S-Corp

Name of Company

Business Address

City and State

County

Postal / Zip code

Member/Shareholder Information

Please provide Name, Title, and % of Ownership of each member/shareholder/boardmember**(% of ownership does not apply to boardmembers)

Thanks for submitting!

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