Foreign Registration – Esquire Assist, Ltd.

Step 1 of 5 - Client Information

20%

Are you and existing client of Esquire Assist?(Required)

Yes

Return Document by

Mail

Your Name and Firm Name(Required)

Email(Required)

Phone(Required)

Address(Required)

Street Address City State Zip Code

Veteran Status

I qualify for a veteran/reservist-owned small business fee exemption

Attach a photo of DD214 or a Military ID Card(Required)

Max. file size: 500 MB.

The Type of Association Entering(Required)

Business Corporation

Nonprofit Corporation

Limited Liability Company

Limited Partnership

Limited Liability (General) Partnership

Limited Liability Limited Partnership

Business Trust

Professional Association

Full and Proper Name as registered in the foreign association’s jurisdiction of formation(Required)

If the name is does not contain a company designator or is not available for use here in PA then state the alternate name under which the association will do business here in PA

The jurisdiction of formation is(Required)

The street and mailing address of the association’s principal office(Required)

Street Address City State ZIP Code

The street and mailing address of the office, if any, required to be maintained by the law of the association’s jurisdiction of formation in that jurisdiction

Street Address City State ZIP Code

Registered Address(Required)

Physical Address within PA

Commercial Registered Office Provider (for those that have no physical address in PA to use or that they do not want to use)

Address of Corporation's Proposed Registered Office(Required)

Number and Street, City, State, Zip, County (post office box alone is not acceptable)

Use AAAgent Servicess, LLC as my Commercial Registered Office Provider?(Required)

Yes

Our Sister company "AAAgent Services, LLC" can provide this service for a very reasonable annual fee.

Name of Commercial Registered Office Provider(Required)

The name of this corporation’s commercial registered office provider.

County(Required)

The county of venue.

Name of Commercial Registered Office Provider(Required)

The name of this corporation’s commercial registered office provider.

County(Required)

The county of venue.

Check one of the following(Required)

The association may not have series.

The association may have one or more series.

Effective date of registration of foreign association(Required)

The Foreign Registration Statement shall be effective upon filing in the Department of State.

The Foreign Registration Statement shall be effective on a specific date

Effective On(Required)

Time

AM/PM

To be completed by Limited Liability Companies only. Check, and if appropriate complete, one of the following:

The association is a limited liability company which is not organized to render any of the below professional service(s).

The association is a restricted professional limited liability company organized to render one or more of the following professional service(s): (If this box is checked, one or more of the fields below must be checked.)

Professional service(s)

Chiropractic

Dentistry

Law

Medicine and surgery

Optometry

Osteopathic medicine and surgery

Podiatric medicine

Public accounting

Psychology

Veterinary medicine

IN TESTIMONY WHEREOF, the undersigned association has caused this Foreign Registration Statement to be signed by a duly authorized representative thereof this

Date(Required)

MM slash DD slash YYYY

Name of Association(Required)

Signature(Required)

By typing your name here you understand that the document will be digitally signed by you as if you manually signed a form.

Title(Required)

Docketing Statement

Company Name	The name of the person responsible for the filing of tax returns	Actions

There are no docketing statements.

Maximum number of docketing statements reached.

How would you like this form submitted?(Required)

Routine

Expedited

Expedited Options(Required)

$100

$300

$1000

Please include any special instructions

Name

This field is for validation purposes and should be left unchanged.