State of Rhode Island and Providence Plantations
Department of State - Business Services Division
Filer Contact Information
In the event our office needs more information in order to complete the filing of this
document, we ask for the filer’s contact information. All fields are REQUIRED.
Name:
Date:
Proposed Entity Name:
Street Address:
City:
State:
Zip Code:
Email Address:
If you have any questions, please call us at (401) 222-3040, Monday through Friday,
between 8:30 a.m. and 4:30 p.m., or email corporations@sos.ri.gov.
FORM 200 - Revised: 05/2016