Instructions For Application For Regional Center Designation Under The Immigrant Investor Program ( Form I-924) (Page 5 of 14) in pdf

Item Number 10.d. Percentage of Ownership In the Entity Listed In Part 4., Item Number 8. Provide the

percentage of ownership of all persons having ownership, control, or beneficial interest in the entity listed in Part 4., Item

Number 8.

Item Number 10.e. Position Held (if any) In the Entity Listed in Part 4., Item Number 8. Provide the titles of the

positions held (if any) of all persons having an ownership, control, or beneficial interest in the entity listed in Part 4.,

Item Number 8.

Item Numbers 11. - 12. Other Names Used By the Owners of the Regional Center Entity (if applicable). Provide any

other names ever used by the owner of the regional center entity, including aliases or trade names (DBA).

Item Numbers 13.a. - 13.i. Mailing Address for the Owners of the Regional Center Entity. Provide the principal’s

mailing address where the printed notices about the application will be sent.

Item Numbers 14. - 17. Contact Information for the Owner of the Regional Center Entity. Provide the principal’s

current telephone number, business fax number, email address (if any), and website (if any).

Information About Principals of the Regional Center Entity - Non-Owners

Item Numbers 18.a. - 18.c. Name. Provide the full legal name for each person who is a principal of but does not hold an

ownership interest in the regional center entity.

Item Numbers 19. - 20. Date of Birth and Country of Birth. Provide the non-owner’s date of birth in mm/dd/yyyy

format and country of birth.

Item Number 21. U.S. Social Security Number. Provide the non-owner’s U.S. Social Security Number.

Item Number 22. Position Held Within the Regional Center Entity. Provide the non-owner’s current title or position

held in the regional center entity.

Item Number 23. Entity Name (for a principal of the Regional Center Entity that is an entity or organization). Provide

the name of each entity that does not hold an ownership interest in the regional center but has a position of executive

managerial authority over the regional center entity or is otherwise in a position to control, influence, or direct the

management or policies of the regional center.

Item Number 24. Federal Employer Identification Number (for a principal of the Regional Center Entity that is an

entity or organization). Provide the Federal Employer Identification Number of the entity listed in Part 4., Item Number

23.

Item Number 25.a. Persons Having Ownership, Control, or Beneficial Interest in the Entity Listed in Part 4., Item

Number 23. Provide the names of all persons having ownership, control, or beneficial interest in the entity listed in Part

4., Item Number 23.

Item Number 25.b. Date of Birth. Provide the date of birth in mm/dd/yyyy format for the person having ownership,

control, or beneficial interest in the entity listed in Part 4., Item Number 23.

Item Number 25.c. Country of Birth. Provide the Country of birth for the person having ownership, control, or

beneficial interest in the entity listed in Part 4., Item Number 23.

Item Number 25.d. Percentage of Ownership in the Principal. Provide the percentage of ownership of all persons

having ownership, control, or beneficial interest in the entity listed in Part 4., Item Number 23.

Item Number 25.e. Position Held in the Non-Natural Principal. Provide the titles of the positions held (if any) of all

persons having an ownership, control, or beneficial interest in the entity listed in Part 4., Item Number 23.

Item Numbers 26.a. - 27. Other Names Used by the Principal Non-Owner of the Regional Center Entity (if

applicable). For each principal, provide other names and aliases used including DBAs (if applicable).

Item Numbers 28.a. - 28.i. Mailing Address for the Principal Non-Owner of the Regional Center Entity. Provide

the address where the principal non-owner can receive printed notices about the application.

Form I-924 Instructions 12/23/16 N

Page 5 of 14

Instructions For Application For Regional Center Designation Under The Immigrant Investor Program ( Form I-924) Page 5