Form Rv-F1308301 - Consolidated Net Worth Election Registration Application Page 3
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4LIST ALL AFFILIATED GROUP MEMBERS OR FINANCIAL INSTITUTION AFFILIATED GROUP MEMBERS NOT
SUBJECT TO TENNESSEE FRANCHISE AND EXCISE TAX
CHECK IF ENTITY IS A SINGLE
NEW MEMBER
REVOKE MEMBER
7. CHECK IF AMENDED:
EFFECTIVE DATE:
MEMBER LLC FILING AS A DIVISION
OF THE PARENT
Affiliated Group Member Name, Mailing Address, and Location Address
FEIN:
Legal Name
Mailing Address - Street/Highway
Location Address - Street/Highway - No PO Box or RR#
City, State, Zip
City, State, Zip:
Business Phone:
Business E-mail:
Business Fax:
DESCRIBE THE BUSINESS ACTIVITY, STATING THE MAJOR PRODUCTS AND/OR SERVICES SOLD.
CHECK IF ENTITY IS A SINGLE
NEW MEMBER
7. CHECK IF AMENDED:
REVOKE MEMBER
EFFECTIVE DATE:
MEMBER LLC FILING AS A DIVISION
OF THE PARENT
Affiliated Group Member Name, Mailing Address, and Location Address
FEIN:
Legal Name
Mailing Address - Street/Highway
Location Address - Street/Highway - No PO Box or RR#
City, State, Zip
City, State, Zip:
Business Phone:
Business E-mail:
Business Fax:
DESCRIBE THE BUSINESS ACTIVITY, STATING THE MAJOR PRODUCTS AND/OR SERVICES SOLD.
NEW MEMBER
CHECK IF ENTITY IS A SINGLE
7. CHECK IF AMENDED:
REVOKE MEMBER
EFFECTIVE DATE:
MEMBER LLC FILING AS A DIVISION
Affiliated Group Member Name, Mailing Address, and Location Address
OF THE PARENT
FEIN:
Legal Name
Mailing Address - Street/Highway
Location Address - Street/Highway - No PO Box or RR#
City, State, Zip
City, State, Zip:
Business Phone:
Business Fax:
Business E-mail:
DESCRIBE THE BUSINESS ACTIVITY, STATING THE MAJOR PRODUCTS AND/OR SERVICES SOLD.
7. CHECK IF AMENDED:
CHECK IF ENTITY IS A SINGLE
NEW MEMBER
REVOKE MEMBER
EFFECTIVE DATE:
MEMBER LLC FILING AS A DIVISION
Affiliated Group Member Name, Mailing Address, and Location Address
OF THE PARENT
FEIN:
Legal Name
Mailing Address - Street/Highway
Location Address - Street/Highway - No PO Box or RR#
City, State, Zip
City, State, Zip:
Business Phone:
Business E-mail:
Business Fax:
DESCRIBE THE BUSINESS ACTIVITY, STATING THE MAJOR PRODUCTS AND/OR SERVICES SOLD.
INTERNET (11-08)
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Parent category: Financial