Form Dos-1343 - Application To Establish Drawdown Account
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1NYS Department of State
Division of Corporations, State Records and UCC
Application to Establish
41 State Street, Albany, NY 12231-0001
Drawdown Account
1. COMPANY OR INDIVIDUAL NAME:
2. MAILING ADDRESS:
3. TELEPHONE NUMBER:
FAX NUMBER:
4. IF BUSINESS, PROVIDE EMPLOYER IDENTIFICATION NUMBER (EIN). IF INDIVIDUAL, PROVIDE SOCIAL SECURITY
NUMBER:
5. NAME OF CONTACT PERSON FOR THIS ACCOUNT:
6. CONTACT PERSON:
MAILING ADDRESS:
E-MAIL ADDRESS(ES):
TELEPHONE NUMBER:
FAX NUMBER:
7. CHECK BOX(ES) FOR SERVICE(S) DESIRED:
Q DIRECT ACCESS TO DATABASE
Q FILING AND OTHER SERVICES
OFFICE USE ONLY: DO NOT WRITE IN THIS SPACE
ACCOUNT NUMBER ASSIGNED:
DOS-1343(2/99)
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Parent category: Legal