Form M-433-Ois - Statement Of Financial Condition And Other Information Page 8
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12Page 8
Part 2. Business Information.
Complete Part 2 even if business is no longer operating.
Business name
Federal Identification number
Business phone number
Business street address (not PO box)
City/Town
State
Zip
County
Type of entity (check one only):
Nature of business
Partnership
Corporation
Other (specify)
Contact name
Title
Contact’s business phone number
Best time to call (enter hour and specify a.m. or p.m.)
Contact’s home phone number
Best time to call (enter hour and specify a.m. or p.m.)
Contact’s alternate phone number (e.g., cell, pager)
Best time to call (enter hour and specify a.m. or p.m.)
1. Person(s) responsible for filing and/or paying trustee taxes. Use additional pages if necessary.
a. Name
Title
Social Security number
Residence address
City/Town
State
Zip
Home phone number
Ownership percentage and number of shares or interest
b. Name
Title
Social Security number
Residence address
City/Town
State
Zip
Home phone number
Ownership percentage and number of shares or interest
2. Partners, officers and/or major shareholders. Use additional pages if necessary.
a. Name
Title (if applicable)
Social Security number
Residence address
City/Town
State
Zip
Home phone number
Ownership percentage and number of shares or interest
b. Name
Title (if applicable)
Social Security number
Residence address
City/Town
State
Zip
Home phone number
Ownership percentage and number of shares or interest
c. Name
Title (if applicable)
Social Security number
Residence address
City/Town
State
Zip
Home phone number
Ownership percentage and number of shares or interest
d. Name
Title (if applicable)
Social Security number
Residence address
City/Town
State
Zip
Home phone number
Ownership percentage and number of shares or interest
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Parent category: Financial