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Submitted URL: https://betterboi.com/
Effective URL: https://form.jotform.com/243038097587164
Submission: On November 20 via api from US — Scanned from DE
Effective URL: https://form.jotform.com/243038097587164
Submission: On November 20 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
Name: form_243038097587164 — POST https://submit.jotform.com/submit/243038097587164
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<ul class="form-section page-section">
<li id="cid_1" class="form-input-wide" data-type="control_head" data-css-selector="id_1">
<div class="form-header-group header-large">
<div class="header-text httac htvam">
<h1 id="header_1" class="form-header" data-component="header">Better BOI</h1>
<div id="subHeader_1" class="form-subHeader">File your BOI form, or Face the Music</div>
</div>
</div>
</li>
<li id="cid_38" class="form-input-wide" data-type="control_head" data-css-selector="id_38">
<div class="form-header-group header-default">
<div class="header-text httal htvam">
<h2 id="header_38" class="form-header" data-component="header">This is required by January 1, 2025</h2>
<div id="subHeader_38" class="form-subHeader">Spill the beans or face the music</div>
</div>
</div>
</li>
<li class="form-line" data-type="control_text" id="id_64" data-css-selector="id_64">
<div id="cid_64" class="form-input-wide">
<div id="text_64" class="form-html" data-component="text" tabindex="0">
<h1>Beneficial Ownership Information Reporting</h1>
<h2>Spill the Beans or Face the Music</h2>
<h3>The New Reality of Business Transparency</h3>
<p><br>After years of uncertainty and shifting deadlines, the Corporate Transparency Act's Beneficial Ownership Information (BOI) reporting requirement is now set in stone. For millions of small businesses, this isn't just another
regulation – it's a mandatory disclosure with serious teeth.</p>
<h3>What's Really Going On Here?</h3>
<p><br>The federal government wants to know who actually owns and controls American businesses. No more hiding behind corporate veils. It's part of a global push for transparency, and this time, they mean business.</p>
<h3>The Hard Facts</h3>
<ul style="list-style-type: disc;">
<li><strong>Final Deadline</strong>: January 1, 2025 for existing companies</li>
<li><strong>New Business</strong>: Must file within 30 days of formation</li>
<li><strong>Changes</strong>: Must update within 30 days of ownership changes</li>
<li><strong>Scope</strong>: Most companies with fewer than 20 employees must file</li>
</ul>
<h3>Let's Talk About Those Penalties</h3>
<p>Because sometimes a spoonful of sugar doesn't help the medicine go down:<br>- <strong>$500 per day</strong> in civil penalties<br>- Criminal fines <strong>up to $10,000</strong><br>- Potential imprisonment up to<strong> 2
years</strong><br>- Permanent compliance record issues</p>
<h3>Who Needs to Report?</h3>
<p>You're probably on the hook if you're a:</p>
<ul style="list-style-type: disc;">
<li>Corporation</li>
<li>LLC</li>
<li>Limited Partnership</li>
<li>Other similar entity</li>
</ul>
<h3>Unless you're:</h3>
<ul style="list-style-type: disc;">
<li>A public company</li>
<li>Already heavily regulated (banks, credit unions)</li>
<li>A tax-exempt organization</li>
<li>Dormant (pre-2020, no activity, no foreign ownership)</li>
</ul>
<h3><strong>Why Now?</strong></h3>
<p><br>The U.S. has been criticized for being a haven for shell companies and financial opacity. This regulation brings us in line with international standards. After multiple false starts and delays, the government is fully committed to
this deadline.</p>
<h3>We Make It Simple</h3>
<p><br>Let's face it – nobody started their business dreaming about filing BOI reports. That's why we're here.</p>
<p>1.<strong> Quick Assessment</strong>: 30-second check to determine if you need to file<br>2.<strong> Streamlined Collection</strong>: Simple forms, clear questions<br>3. <strong>Secure Filing</strong>: We handle the FinCEN
submission<br>4. <strong>Peace of Mind</strong>: Updates and reminders when needed</p>
<h3>Why Act Now?</h3>
<p><br>Think of January 1, 2025 like tax day – you don't want to be scrambling with millions of other business owners at the last minute. Get it done now, and get back to running your business.</p>
<p>Click on the blue button below to start your BOI Reporting </p>
<p>No payment required to check if you need to file</p>
<h3>The Bottom Line</h3>
<p>This isn't just another piece of paperwork you can ignore. The penalties are serious, the deadline is firm, and the government is committed to enforcement. But with our help, you can knock this out quickly and correctly.</p>
<h3>Still Not Sure?</h3>
<p><br><strong><em>"But what if the requirements change again?"</em></strong><br>They might adjust some details, but the core requirement isn't going away. Filing early means you're covered, and we'll help you update if needed.</p>
<p><em><strong>"What about privacy concerns?"</strong></em><br>We take your privacy seriously, and FinCEN has strict data protection protocols. This isn't public information – it's confidential government reporting.</p>
<p><em><strong>"Can't I just do this myself?"<br></strong></em>We help you complete your BOI Reporting requirements for a flat fee, starting at $250 for a simple report and going to $1,000+ for complex situations. We offer hands on
support and a white glove option, so you can get back to work!</p>
<p><em><strong>"Can't I just do this myself?"</strong></em><br>Yes! We would love for you to do this yourself. See the guide we have built for self-filers. If you have any questions along the way you can schedule time with us.</p>
<p>Click the blue button below to get started, and see if you need to file!</p>
<p>---<br>*Note: While we keep things light, we take compliance seriously. Our process is designed for accuracy and completeness, backed by thorough understanding of FinCEN requirements.*</p>
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<div class="form-pagebreak-next-container"><button id="form-pagebreak-next_69" type="button" class="form-pagebreak-next form-submit-button-simple_blue jf-form-buttons"
data-component="pagebreak-next">Do I need to file?</button></div>
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data-component="button">Save</button></div>
<div style="clear:both" class="pageInfo form-sub-label" id="pageInfo_69"></div>
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</li>
</ul>
<ul class="form-section page-section" style="display:none;">
<li id="cid_63" class="form-input-wide" data-type="control_head" data-css-selector="id_63">
<div class="form-header-group header-default">
<div class="header-text httal htvam">
<h2 id="header_63" class="form-header" data-component="header">Exemption Criteria</h2>
<div id="subHeader_63" class="form-subHeader">You might just get a free pass</div>
</div>
</div>
</li>
<li class="form-line" data-type="control_text" id="id_62" data-css-selector="id_62">
<div id="cid_62" class="form-input-wide">
<div id="text_62" class="form-html" data-component="text" tabindex="0">
<h2>Do you need to file?</h2>
<p>There are a number of exemption criteria where your company might consolidate the number of BOI forms it must file, or avoid filing BOI altogether.</p>
<p><strong>Exemption</strong> requirements might include:</p>
<ul style="list-style-type: square;">
<li>Securities Reporting Issuer: Publicly traded companies that meet certain requirements.</li>
<li>Governmental Authority: Entities established by a government.</li>
<li>Bank: Banks that are regulated and meet certain criteria.</li>
<li>Credit Union: Federally insured credit unions.</li>
<li>Depository Institution Holding Company.</li>
<li>Money Services Business.</li>
<li>Broker or Dealer in Securities.</li>
<li>Securities Exchange or Clearing Agency.</li>
<li>Other Exchange Act Registered Entity.</li>
<li>Investment Company or Investment Adviser.</li>
<li>Venture Capital Fund Adviser.</li>
<li>Insurance Company.</li>
<li>State-Licensed Insurance Producer.</li>
<li>Commodity Exchange Act Registered Entity.</li>
<li>Accounting Firm.</li>
<li>Public Utility.</li>
<li>Financial Market Utility.</li>
<li>Pooled Investment Vehicle.</li>
<li>Tax-Exempt Entity: Nonprofits and similar entities.</li>
<li>Entity Assisting a Tax-Exempt Entity.</li>
<li>Large Operating Company: Companies that employ more than 20 people in the U.S., have over $5 million in gross revenue on their last tax return, <strong>and</strong> have a physical presence in the U.S.</li>
<li>Subsidiary of Certain Exempt Entities.</li>
<li>Inactive Entity: Since prior to 2020, no activity, no foreign ownership)</li>
</ul>
</div>
</div>
</li>
<li class="form-line jf-required" data-type="control_radio" id="id_60" data-css-selector="id_60"><label class="form-label form-label-top form-label-auto" id="label_60" aria-hidden="false"> Does your company meet ANY of these exemption
criteria?<span class="form-required">*</span> </label>
<div id="cid_60" class="form-input-wide jf-required">
<div class="form-single-column" role="group" aria-labelledby="label_60" data-component="radio"><span class="form-radio-item" style="clear:left"><span class="dragger-item"></span><input aria-describedby="label_60" type="radio"
class="form-radio validate[required]" id="input_60_0" name="q60_Exemption" required="" value="Based on one or more of these factors, I am an exempt entity."><label id="label_input_60_0" for="input_60_0">Based on one or more of these
factors, I am an exempt entity.</label></span><span class="form-radio-item" style="clear:left"><span class="dragger-item"></span><input aria-describedby="label_60" type="radio" class="form-radio validate[required]" id="input_60_1"
name="q60_Exemption" required="" value="None of these apply - I need to file"><label id="label_input_60_1" for="input_60_1">None of these apply - I need to file</label></span><span class="form-radio-item" style="clear:left"><span
class="dragger-item"></span><input aria-describedby="label_60" type="radio" class="form-radio validate[required]" id="input_60_2" name="q60_Exemption" required="" value="I am not sure"><label id="label_input_60_2" for="input_60_2">I
am not sure</label></span></div>
</div>
</li>
<li id="cid_71" class="form-input-wide" data-type="control_pagebreak" data-css-selector="id_71">
<div class="form-pagebreak" data-component="pagebreak">
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<div style="clear:both" class="pageInfo form-sub-label" id="pageInfo_71"></div>
</div>
</li>
</ul>
<ul class="form-section page-section" style="display:none;">
<li id="cid_80" class="form-input-wide" data-type="control_head" data-css-selector="id_80">
<div class="form-header-group header-default">
<div class="header-text httal htvam">
<h2 id="header_80" class="form-header" data-component="header">Good News!</h2>
<div id="subHeader_80" class="form-subHeader">You might just get a free pass</div>
</div>
</div>
</li>
<li class="form-line" data-type="control_text" id="id_72" data-css-selector="id_72">
<div id="cid_72" class="form-input-wide">
<div id="text_72" class="form-html" data-component="text" tabindex="0">
<h2>Good News! You May Be Exempt from BOI Reporting</h2>
<p>Based on your response, your company likely qualifies for an exemption from BOI reporting requirements.</p>
<h3>⚠️ Important Next Steps:</h3>
<p><br><strong>1. Document Your Exemption Status</strong><br> - Keep records showing why you qualify for exemption<br> - Save relevant documentation (like SEC filings, tax-exempt status, etc.)</p>
<p><strong>2. Verify Your Status</strong><br> - While our assessment indicates you're exempt, we recommend:</p>
<ul style="list-style-type: disc;">
<li>Consulting with your legal counsel</li>
<li>Reviewing the full [FinCEN exemption guidelines](https://www.fincen.gov)</li>
<li>Documenting your exemption determination</li>
</ul>
<p><strong>3. Stay Informed</strong><br> - Exemption status can change if:</p>
<ul style="list-style-type: disc;">
<li>Your business structure changes</li>
<li>You lose tax-exempt status</li>
<li>Regulatory requirements are updated</li>
<li>Sign up for our updates to stay informed of any changes</li>
</ul>
<p><a href="https://baldridgecpa.ck.page/65362576f9" target="_blank" rel="nofollow">Sign Up for BOI Regulation Updates</a></p>
<h2>Need More Help?</h2>
<p><br>If you'd like a professional review of your exemption status or have questions, we're here to help.</p>
<p><a href="https://calendly.com/roger-279/boi" target="_blank" rel="nofollow">Schedule a Consultation</a></p>
</div>
</div>
</li>
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<div class="form-pagebreak" data-component="pagebreak">
<div class="form-pagebreak-back-container"><button id="form-pagebreak-back_77" type="button" class="form-pagebreak-back form-submit-button-simple_white jf-form-buttons" data-component="pagebreak-back">Back</button></div>
<div class="form-pagebreak-next-container"><button id="form-pagebreak-next_77" type="button" class="form-pagebreak-next form-submit-button-simple_white button-hidden jf-form-buttons" data-component="pagebreak-next">Next</button></div>
<div class="form-pagebreak-next-container form-pagebreak-save-container"><button id="input_scl_77" type="button" class="form-submit-button form-sacl-button js-new-sacl-button form-submit-button-simple_white jf-form-buttons sacl-button"
data-component="button" disabled="">Save</button></div>
<div style="clear:both" class="pageInfo form-sub-label" id="pageInfo_77"></div>
</div>
</li>
</ul>
<ul class="form-section page-section" style="display:none;">
<li id="cid_81" class="form-input-wide" data-type="control_head" data-css-selector="id_81">
<div class="form-header-group header-default">
<div class="header-text httal htvam">
<h2 id="header_81" class="form-header" data-component="header">Need help?</h2>
<div id="subHeader_81" class="form-subHeader">Consult with us to get down the road</div>
</div>
</div>
</li>
<li class="form-line" data-type="control_text" id="id_79" data-css-selector="id_79">
<div id="cid_79" class="form-input-wide">
<div id="text_79" class="form-html" data-component="text" tabindex="0">
<h2>Let's Sort Out Your BOI Filing Together</h2>
<h3>Simple. Personal. Done Right.</h3>
<p>Confused about BOI requirements? Don't worry. In one phone call, we'll:<br>- Determine if you need to file<br>- Collect the right information<br>- Handle the submission process<br>- Ensure you're fully compliant</p>
<p>No complicated forms. No legal jargon. Just clear guidance from a real person who knows BOI inside and out.</p>
<p><strong>How It Works</strong><br>1. Schedule a 30-minute call below<br>2. We'll walk you through everything step by step<br>3. You'll have peace of mind knowing it's handled correctly</p>
<p><strong>Why Talk With Us?</strong><br>- ✓ No prep needed - we'll guide you through it<br>- ✓ Get answers to all your questions<br>- ✓ Save hours of research and confusion<br>- ✓ Avoid costly mistakes and penalties</p>
<p><strong>$500 Consultation Fee**</strong><br>*Includes simple BOI filing if needed*</p>
<p><em>"We make BOI compliance as painless as a 30-minute call."</em></p>
</div>
</div>
</li>
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<ul class="form-section page-section" style="display:none;">
<li id="cid_82" class="form-input-wide" data-type="control_head" data-css-selector="id_82">
<div class="form-header-group header-default">
<div class="header-text httal htvam">
<h2 id="header_82" class="form-header" data-component="header">Let's get to work!</h2>
<div id="subHeader_82" class="form-subHeader">First, let's confirm your authorization to file.</div>
</div>
</div>
</li>
<li class="form-line jf-required" data-type="control_textbox" id="id_44" data-css-selector="id_44" style="z-index: 0;"><label class="form-label form-label-top form-label-auto" id="label_44" for="input_44" aria-hidden="false"> Name of Reporting
Company<span class="form-required">*</span> </label>
<div id="cid_44" class="form-input-wide jf-required"> <input type="text" id="input_44" name="q44_nameOf" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="20" data-component="textbox"
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<div class="form-description" style="display: none;">
<div class="form-description-arrow"></div>
<div class="form-description-arrow-small"></div>
<div class="form-description-content">The Legal Name of your company on your tax returns.</div>
</div>
</li>
<li class="form-line jf-required" data-type="control_number" id="id_110" data-css-selector="id_110" style="z-index: 0;"><label class="form-label form-label-top form-label-auto" id="label_110" for="input_110" aria-hidden="false"> How many
beneficial owners are there in the company?<span class="form-required">*</span> </label>
<div id="cid_110" class="form-input-wide jf-required"> <input type="number" id="input_110" name="q110_howMany" data-type="input-number" class=" form-number-input form-textbox validate[required]" data-defaultvalue="" style="width:60px"
size="5" placeholder="e.g., 2" data-component="number" aria-labelledby="label_110" required="" step="any" value=""> </div>
<div class="form-description" style="display: none;">
<div class="form-description-arrow"></div>
<div class="form-description-arrow-small"></div>
<div class="form-description-content">Count individuals who EITHER:<br>- Own 25% or more of the company, OR<br>- Exercise substantial control (senior officers, key decisions)<br><br>Each person may only be counted once, even if they meet
both criteria.</div>
</div>
</li>
<li class="form-line jf-required calculatedOperand" data-type="control_fullname" id="id_95" data-css-selector="id_95"><label class="form-label form-label-top form-label-auto" id="label_95" for="first_95" aria-hidden="false"> Your First and Last
Name<span class="form-required">*</span> </label>
<div id="cid_95" class="form-input-wide jf-required">
<div data-wrapper-react="true"><span class="form-sub-label-container" style="vertical-align:top" data-input-type="first"><input type="text" id="first_95" name="q95_yourFirst[first]" class="form-textbox validate[required]"
data-defaultvalue="" autocomplete="section-input_95 given-name" size="10" data-component="first" aria-labelledby="label_95 sublabel_95_first" required="" value=""><label class="form-sub-label" for="first_95" id="sublabel_95_first"
style="min-height:13px">First Name</label></span><span class="form-sub-label-container" style="vertical-align:top" data-input-type="last"><input type="text" id="last_95" name="q95_yourFirst[last]"
class="form-textbox validate[required]" data-defaultvalue="" autocomplete="section-input_95 family-name" size="15" data-component="last" aria-labelledby="label_95 sublabel_95_last" required="" value=""><label class="form-sub-label"
for="last_95" id="sublabel_95_last" style="min-height:13px">Last Name</label></span></div>
</div>
</li>
<li class="form-line jf-required" data-type="control_email" id="id_8" data-css-selector="id_8"><label class="form-label form-label-top form-label-auto" id="label_8" for="input_8" aria-hidden="false"> Email Address<span
class="form-required">*</span> </label>
<div id="cid_8" class="form-input-wide jf-required"> <span class="form-sub-label-container" style="vertical-align:top"><input type="email" id="input_8" name="q8_emailAddress" class="form-textbox validate[required, Email]" data-defaultvalue=""
autocomplete="section-input_8 email" size="30" data-component="email" aria-labelledby="label_8 sublabel_input_8" required="" value=""><label class="form-sub-label" for="input_8" id="sublabel_input_8"
style="min-height:13px">example@example.com</label></span> </div>
</li>
<li class="form-line" data-type="control_phone" id="id_45" data-css-selector="id_45"><label class="form-label form-label-top form-label-auto" id="label_45" for="input_45_area" aria-hidden="false"> Phone Number </label>
<div id="cid_45" class="form-input-wide">
<div data-wrapper-react="true"><span class="form-sub-label-container" style="vertical-align:top" data-input-type="areaCode"><input type="tel" id="input_45_area" name="q45_phoneNumber45[area]" class="form-textbox" data-defaultvalue=""
autocomplete="section-input_45 tel-area-code" data-component="areaCode" aria-labelledby="label_45 sublabel_45_area" value=""><span class="phone-separate" aria-hidden="true"> -</span><label class="form-sub-label"
for="input_45_area" id="sublabel_45_area" style="min-height:13px">Area Code</label></span><span class="form-sub-label-container" style="vertical-align:top" data-input-type="phone"><input type="tel" id="input_45_phone"
name="q45_phoneNumber45[phone]" class="form-textbox" data-defaultvalue="" autocomplete="section-input_45 tel-local" data-component="phone" aria-labelledby="label_45 sublabel_45_phone" value=""><label class="form-sub-label"
for="input_45_phone" id="sublabel_45_phone" style="min-height:13px">Phone Number</label></span></div>
</div>
</li>
<li class="form-line jf-required" data-type="control_checkbox" id="id_86" data-css-selector="id_86"><label class="form-label form-label-top form-label-auto" id="label_86" aria-hidden="false"> Please confirm the following:<span
class="form-required">*</span> </label>
<div id="cid_86" class="form-input-wide jf-required">
<div class="form-single-column" role="group" aria-labelledby="label_86" data-component="checkbox"><span class="form-checkbox-item" style="clear:left"><span class="dragger-item"></span><input aria-describedby="label_86" type="checkbox"
class="form-checkbox validate[required, maxselection,minselection]" id="input_86_0" name="q86_typeA86[]" required="" data-maxselection="3" data-minselection="3" value="I am authorized to file BOI reports for this company"><label
id="label_input_86_0" for="input_86_0">I am authorized to file BOI reports for this company</label></span><span class="form-checkbox-item" style="clear:left"><span class="dragger-item"></span><input aria-describedby="label_86"
type="checkbox" class="form-checkbox validate[required, maxselection,minselection]" id="input_86_1" name="q86_typeA86[]" required="" data-maxselection="3" data-minselection="3"
value="I understand that providing false information may result in penalties"><label id="label_input_86_1" for="input_86_1">I understand that providing false information may result in penalties</label></span><span
class="form-checkbox-item" style="clear:left"><span class="dragger-item"></span><input aria-describedby="label_86" type="checkbox" class="form-checkbox validate[required, maxselection,minselection]" id="input_86_2" name="q86_typeA86[]"
required="" data-maxselection="3" data-minselection="3" value="I agree to notify of any changes within 30 days"><label id="label_input_86_2" for="input_86_2">I agree to notify of any changes within 30 days</label></span></div>
</div>
</li>
<li class="form-line jf-required" data-type="control_widget" id="id_32" data-css-selector="id_32">
<div id="cid_32" class="form-input-wide jf-required">
<div data-widget-name="Terms &amp; Conditions" style="width:100%;text-align:Left;overflow-x:auto" data-component="widget-field"><iframe data-client-id="52948fb29322cd302b00000c" title="Terms &amp; Conditions" frameborder="0"
scrolling="no" allowtransparency="true" allow="geolocation; microphone; camera; autoplay; encrypted-media; fullscreen" data-type="iframe" class="custom-field-frame custom-field-frame-rendered frame-xd-ready" id="customFieldFrame_32"
src="//widgets.jotform.io/termsConditions/?qid=32&isOpenedInPortal=undefined&isOpenedInAgent=undefined&align=Left&ref=https%3A%2F%2Fform.jotform.com&injectCSS=false"
style="max-width:580px;border:none;width:100%;height:50px" data-width="580" data-height="50"></iframe>
<div class="widget-inputs-wrapper"><input id="input_32" class="form-hidden form-widget widget-required " type="hidden" name="q32_typeA" value=""><input id="widget_settings_32" class="form-hidden form-widget-settings" type="hidden"
data-version="2"
value="%5B%7B%22name%22%3A%22termsText%22%2C%22value%22%3A%22I%20agree%20to%20the%20%7Bterms%20and%20conditions%7D%20and%20I%20also%20confirm%20that%20all%20information%20I%20entered%20in%20this%20form%20is%20accurate%20and%20true.%22%7D%2C%7B%22name%22%3A%22theme%22%2C%22value%22%3A%22default%22%7D%2C%7B%22name%22%3A%22acceptedText%22%2C%22value%22%3A%22Accepted%22%7D%5D">
</div>
<script type="text/javascript">
setTimeout(function() {
var _cFieldFrame = document.getElementById("customFieldFrame_32");
if (_cFieldFrame) {
_cFieldFrame.onload = function() {
if (typeof widgetFrameLoaded !== 'undefined') {
widgetFrameLoaded(32, {
"formID": 243038097587164
}, undefined)
}
};
_cFieldFrame.src = "//widgets.jotform.io/termsConditions/?qid=32&isOpenedInPortal=undefined&isOpenedInAgent=undefined&align=Left&ref=" + encodeURIComponent(window.location.protocol + "//" + window.location.host) + '' + '' + '' +
'&injectCSS=' + encodeURIComponent(window.location.search.indexOf("ndt=1") > -1);
_cFieldFrame.addClassName("custom-field-frame-rendered");
}
}, 0);
</script>
</div>
</div>
</li>
<li class="form-line jf-required" data-type="control_signature" id="id_34" data-css-selector="id_34"><label class="form-label form-label-top form-label-auto" id="label_34" for="input_34" aria-hidden="false"> Authorized Applicant's
Signature<span class="form-required">*</span> </label>
<div id="cid_34" class="form-input-wide jf-required">
<div data-wrapper-react="true">
<div id="signature_pad_34" class="signature-pad-wrapper">
<div data-wrapper-react="true">
<!--[if IE 7]><script type="text/javascript" src="/js/vendor/json2.js"></script><![endif]-->
</div>
<div class="signature-line signature-wrapper signature-placeholder" data-component="signature">
<div id="sig_pad_34" data-width="400" data-height="200" data-id="34" data-required="true" class="pad validate[required]" aria-description="Use your pointer or touch input to draw your signature." aria-labelledby="label_34"
tabindex="0">
<div style="padding:0 !important; margin:0 !important;width: 100% !important; height: 0 !important; -ms-touch-action: none; touch-action: none;margin-top:-1em !important; margin-bottom:1em !important;"></div><canvas
class="jSignature" width="400" style="margin: 0px; padding: 0px; border: none; height: 200px; width: 400px; touch-action: none; background-color: rgb(255, 255, 255);" height="200"></canvas>
<div style="padding:0 !important; margin:0 !important;width: 100% !important; height: 0 !important; -ms-touch-action: none; touch-action: none;margin-top:-1.5em !important; margin-bottom:1.5em !important; position: relative;"></div>
</div><input type="hidden" name="q34_authorizedApplicants" class="output4" id="input_34">
</div>
<aside class="signature-pad-aside">
<a style="margin-top:2px;font-size:10px;color:inherit;text-decoration:none" href="https://www.jotform.com/products/sign?utm_source=sign_cardform&utm_content=form&utm_medium=button&utm_campaign=sign_form_integration" target="_blank">Powered by <span style="color:#57810b;font-weight:700">Jotform Sign</span></a><span
class="clear-pad-btn clear-pad" role="button" tabindex="0">Clear</span></aside>
</div>
<div data-wrapper-react="true">
<script type="text/javascript">
window.signatureForm = true
</script>
</div>
</div>
</div>
</li>
<li id="cid_121" class="form-input-wide" data-type="control_pagebreak" data-css-selector="id_121">
<div class="form-pagebreak" data-component="pagebreak">
<div class="form-pagebreak-back-container"><button id="form-pagebreak-back_121" type="button" class="form-pagebreak-back form-submit-button-simple_white jf-form-buttons" data-component="pagebreak-back">Back</button></div>
<div class="form-pagebreak-next-container"><button id="form-pagebreak-next_121" type="button" class="form-pagebreak-next form-submit-button-simple_white jf-form-buttons" data-component="pagebreak-next">Next</button></div>
<div class="form-pagebreak-next-container form-pagebreak-save-container"><button id="input_scl_121" type="button" class="form-submit-button form-sacl-button js-new-sacl-button form-submit-button-simple_white jf-form-buttons sacl-button"
data-component="button" disabled="">Save</button></div>
<div style="clear:both" class="pageInfo form-sub-label" id="pageInfo_121"></div>
</div>
</li>
</ul>
<ul class="form-section page-section" style="display:none;">
<li id="cid_190" class="form-input-wide" data-type="control_head" data-css-selector="id_190">
<div class="form-header-group header-default">
<div class="header-text httal htvam">
<h2 id="header_190" class="form-header" data-component="header">Choose your service</h2>
</div>
</div>
</li>
<li class="form-line card-1col jf-required" data-type="control_stripeCheckout" id="id_115" data-payment="true" data-css-selector="id_115"><label class="form-label form-label-top form-label-auto" id="label_115" for="input_115"
aria-hidden="false"> Note - you will not pay until you have completed the forms, but you will not be able to submit the forms without payment<span class="form-required">*</span> </label>
<div id="cid_115" class="form-input-wide jf-required">
<div data-wrapper-react="true">
<div data-wrapper-react="true" class="product-container-wrapper">
<div class="filter-container"></div><input type="hidden" name="simple_fpc" data-payment_type="stripeCheckout" data-component="payment1" value="115"><input type="hidden" name="payment_transaction_uuid" id="paymentTransactionId"
value="0193479e2fe47d26bc817122064a6fcabaf8"><input type="hidden" name="payment_version" id="payment_version" value="4"><input type="hidden" name="payment_total_checksum" id="payment_total_checksum" data-component="payment2"><input
type="hidden" name="payment_discount_value" id="payment_discount_value" data-component="payment3">
<div id="image-overlay" class="overlay-content" style="display:none"><img id="current-image"><span class="lb-prev-button">prev</span><span class="lb-next-button">next</span><span class="lb-close-button">( X )</span><span
class="image-overlay-product-container">
<ul class="form-overlay-item" pid="1000" hasicon="false" hasimages="false" iconvalue=""></ul>
<ul class="form-overlay-item" pid="1001" hasicon="false" hasimages="false" iconvalue=""></ul>
<ul class="form-overlay-item" pid="1002" hasicon="false" hasimages="false" iconvalue=""></ul>
</span></div>
<div data-wrapper-react="true"><span class="form-product-item hover-product-item " categories="non-categorized" pid="1000">
<div data-wrapper-react="true" class="form-product-item-detail"><input class="form-radio validate[required] form-product-input" type="radio" id="input_115_1000" name="q115_myProducts[][id]" data-is-default-required="false"
data-is-default-selected="false" aria-label="Select Product: Simple BOI - up to 2 Beneficial Owners" value="1000"><label for="input_115_1000" class="form-product-container"><span data-wrapper-react="true"><span
class="form-product-name" id="product-name-input_115_1000">Simple BOI - up to 2 Beneficial Owners</span><span
class="form-product-details"><b><span data-wrapper-react="true">$<span id="input_115_1000_price">250.00</span></span></b></span></span>
<div class="form-product-description" id="product-name-description-input_115_1000">Completion of a BOI Report with up to 2 Beneficial Owners. Includes Audit Protection.</div>
</label></div>
</span><br><span class="form-product-item hover-product-item " categories="non-categorized" pid="1001">
<div data-wrapper-react="true" class="form-product-item-detail"><input class="form-radio validate[required] form-product-input" type="radio" id="input_115_1001" name="q115_myProducts[][id]" data-is-default-required="false"
data-is-default-selected="false" aria-label="Select Product: Complex BOI - 3+ Beneficial Owners" value="1001"><label for="input_115_1001" class="form-product-container"><span data-wrapper-react="true"><span
class="form-product-name" id="product-name-input_115_1001">Complex BOI - 3+ Beneficial Owners</span><span
class="form-product-details"><b><span data-wrapper-react="true">$<span id="input_115_1001_price">500.00</span></span></b></span></span>
<div class="form-product-description" id="product-name-description-input_115_1001">Completion of a BOI Report with 3+ Beneficial Owners. Includes Audit Protection.</div>
</label></div>
</span><br><span class="form-product-item hover-product-item " categories="non-categorized" pid="1002">
<div data-wrapper-react="true" class="form-product-item-detail"><input class="form-radio validate[required] form-product-input" type="radio" id="input_115_1002" name="q115_myProducts[][id]" data-is-default-required="false"
data-is-default-selected="false" aria-label="Select Product: Done For You BOI" value="1002"><label for="input_115_1002" class="form-product-container"><span data-wrapper-react="true"><span class="form-product-name"
id="product-name-input_115_1002">Done For You BOI</span><span class="form-product-details"><b><span data-wrapper-react="true">$<span id="input_115_1002_price">1,000.00</span></span></b></span></span>
<div class="form-product-description" id="product-name-description-input_115_1002">Completion of a BOI Report with 1-3+ Beneficial Owners. Includes Audit Protection. We will request documents and complete this form for you!
Includes one 30 minute call if necessary.</div>
</label></div>
</span><br>
<div id="coupon-container" style="border:1px solid lightgray;padding:5px;border-radius:6px;width:200px;margin-top:8px">
<table id="coupon-table">
<tbody>
<tr>
<th colspan="2" style="text-align:left"><label id="coupon-header" for="coupon-input">Enter coupon</label></th>
</tr>
<tr>
<td><input name="coupon-input" id="coupon-input" data-stripe="false" type="text" size="15" autocomplete="off" aria-labelledby="coupon-header coupon-message"></td>
<td width="40%" style="text-align:center"><img loading="lazy" src="https://cdn.jotfor.ms//images/ajax-loader.gif" alt="coupon loading" id="coupon-loader" style="display:none;vertical-align:top"><button type="button"
id="coupon-button" data-qid="input_115" value="">Apply</button></td>
</tr>
<tr>
<th colspan="2" style="text-align:left"><span id="coupon-message" role="alert"></span></th>
</tr>
</tbody>
</table>
</div><br><input id="input_115_coupon" type="hidden" name="coupon" value=""><span
class="form-payment-total"><b><span id="total-text">Total</span> <span class="form-payment-price"><span data-wrapper-react="true">$<span id="payment_total">0.00</span></span></span></b></span>
</div>
</div>
</div>
</div>
</li>
<li id="cid_78" class="form-input-wide" data-type="control_pagebreak" data-css-selector="id_78">
<div class="form-pagebreak" data-component="pagebreak">
<div class="form-pagebreak-back-container"><button id="form-pagebreak-back_78" type="button" class="form-pagebreak-back jf-form-buttons" data-component="pagebreak-back">Back</button></div>
<div class="form-pagebreak-next-container"><button id="form-pagebreak-next_78" type="button" class="form-pagebreak-next jf-form-buttons" data-component="pagebreak-next">Next</button></div>
<div class="form-pagebreak-next-container form-pagebreak-save-container"><button id="input_scl_78" type="button" class="form-submit-button form-sacl-button js-new-sacl-button jf-form-buttons sacl-button" data-component="button"
disabled="">Save</button></div>
<div style="clear:both" class="pageInfo form-sub-label" id="pageInfo_78"></div>
</div>
</li>
</ul>
<ul class="form-section page-section" style="display:none;">
<li id="cid_59" class="form-input-wide" data-type="control_head" data-css-selector="id_59">
<div class="form-header-group header-default">
<div class="header-text httal htvam">
<h2 id="header_59" class="form-header" data-component="header">Company Applicant Information</h2>
</div>
</div>
</li>
<li class="form-line jf-required" data-type="control_fullname" id="id_3" data-compound-hint="," data-css-selector="id_3"><label class="form-label form-label-top form-label-auto" id="label_3" for="first_3" aria-hidden="false"> Name<span
class="form-required">*</span> </label>
<div id="cid_3" class="form-input-wide jf-required">
<div data-wrapper-react="true"><span class="form-sub-label-container" style="vertical-align:top" data-input-type="first"><input type="text" id="first_3" name="q3_name[first]" class="form-textbox validate[required]" data-defaultvalue=""
autocomplete="section-input_3 given-name" size="10" data-component="first" aria-labelledby="label_3 sublabel_3_first" required="" value=""><label class="form-sub-label" for="first_3" id="sublabel_3_first" style="min-height:13px">First
Name</label></span><span class="form-sub-label-container" style="vertical-align:top" data-input-type="last"><input type="text" id="last_3" name="q3_name[last]" class="form-textbox validate[required]" data-defaultvalue=""
autocomplete="section-input_3 family-name" size="15" data-component="last" aria-labelledby="label_3 sublabel_3_last" required="" value=""><label class="form-sub-label" for="last_3" id="sublabel_3_last" style="min-height:13px">Last
Name</label></span></div>
</div>
</li>
<li class="form-line jf-required" data-type="control_datetime" id="id_96" data-css-selector="id_96"><label class="form-label form-label-top form-label-auto" id="label_96" for="lite_mode_96" aria-hidden="false"> Date of Birth<span
class="form-required">*</span> </label>
<div id="cid_96" class="form-input-wide jf-required">
<div data-wrapper-react="true">
<div style="display:none"><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[required, limitDate]" id="month_96" name="q96_dateOf[month]" type="tel" size="2" data-maxlength="2"
data-age="" maxlength="2" required="" autocomplete="off" aria-labelledby="label_96 sublabel_96_month" value=""><span class="date-separate" aria-hidden="true"> -</span><label class="form-sub-label" for="month_96"
id="sublabel_96_month" style="min-height:13px">Month</label></span><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[required, limitDate]" id="day_96" name="q96_dateOf[day]"
type="tel" size="2" data-maxlength="2" data-age="" maxlength="2" required="" autocomplete="off" aria-labelledby="label_96 sublabel_96_day" value=""><span class="date-separate" aria-hidden="true"> -</span><label
class="form-sub-label" for="day_96" id="sublabel_96_day" style="min-height:13px">Day</label></span><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[required, limitDate]"
id="year_96" name="q96_dateOf[year]" type="tel" size="4" data-maxlength="4" data-age="" maxlength="4" required="" autocomplete="off" aria-labelledby="label_96 sublabel_96_year" value=""><label class="form-sub-label" for="year_96"
id="sublabel_96_year" style="min-height:13px">Year</label></span></div><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[required, limitDate, validateLiteDate]" id="lite_mode_96"
type="text" size="12" data-maxlength="12" maxlength="12" data-age="" required="" data-format="mmddyyyy" data-seperator="-" placeholder="mm-dd-yyyy" data-placeholder="MM-DD-YYYY" autocomplete="off"
aria-labelledby="label_96 sublabel_96_litemode" value=""><img class=" newDefaultTheme-dateIcon icon-liteMode" alt="Pick a Date" id="input_96_pick" src="https://cdn.jotfor.ms/images/calendar.png" data-component="datetime"
aria-hidden="false" data-allow-time="No" data-version="v1" aria-label="Choose Date" role="button" tabindex="0" aria-haspopup="dialog" aria-expanded="false"><label class="form-sub-label" for="lite_mode_96" id="sublabel_96_litemode"
style="min-height:13px">Date</label></span>
</div>
</div>
</li>
<li class="form-line" data-type="control_textbox" id="id_97" data-css-selector="id_97"><label class="form-label form-label-top form-label-auto" id="label_97" for="input_97" aria-hidden="false"> FinCEN ID (if applicable) </label>
<div id="cid_97" class="form-input-wide"> <input type="text" id="input_97" name="q97_typeA97" data-type="input-textbox" class="form-textbox" data-defaultvalue="" size="20" data-component="textbox" aria-labelledby="label_97" value=""> </div>
</li>
<li class="form-line jf-required" data-type="control_address" id="id_9" data-css-selector="id_9"><label class="form-label form-label-top form-label-auto" id="label_9" for="input_9_addr_line1" aria-hidden="false"> Current Address<span
class="form-required">*</span> </label>
<div id="cid_9" class="form-input-wide jf-required">
<div summary="" class="form-address-table jsTest-addressField">
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-street-line jsTest-address-lineField"><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_9_addr_line1" name="q9_currentAddress[addr_line1]" class="form-textbox validate[required] form-address-line" data-defaultvalue="" autocomplete="section-input_9 address-line1" data-component="address_line_1"
aria-labelledby="label_9 sublabel_9_addr_line1" required="" value="" maxlength="100"><label class="form-sub-label" for="input_9_addr_line1" id="sublabel_9_addr_line1" style="min-height:13px">Street Address</label></span></span>
</div>
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-street-line jsTest-address-lineField"><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_9_addr_line2" name="q9_currentAddress[addr_line2]" class="form-textbox form-address-line" data-defaultvalue="" autocomplete="section-input_9 address-line2" data-component="address_line_2"
aria-labelledby="label_9 sublabel_9_addr_line2" value="" maxlength="100"><label class="form-sub-label" for="input_9_addr_line2" id="sublabel_9_addr_line2" style="min-height:13px">Street Address Line 2</label></span></span></div>
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-city-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_9_city" name="q9_currentAddress[city]" class="form-textbox validate[required] form-address-city" data-defaultvalue="" autocomplete="section-input_9 address-level2" data-component="city"
aria-labelledby="label_9 sublabel_9_city" required="" value="" maxlength="60"><label class="form-sub-label" for="input_9_city" id="sublabel_9_city" style="min-height:13px">City</label></span></span><span
class="form-address-line form-address-state-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><select class="form-dropdown validate[required] form-address-state"
name="q9_currentAddress[state]" id="input_9_state" data-component="state" required="" aria-labelledby="label_9 sublabel_9_state" autocomplete="section-input_9 address-level1">
<option value="" selected="">Please Select</option>
<option value="Alabama">Alabama</option>
<option value="Alaska">Alaska</option>
<option value="Arizona">Arizona</option>
<option value="Arkansas">Arkansas</option>
<option value="California">California</option>
<option value="Colorado">Colorado</option>
<option value="Connecticut">Connecticut</option>
<option value="Delaware">Delaware</option>
<option value="District of Columbia">District of Columbia</option>
<option value="Florida">Florida</option>
<option value="Georgia">Georgia</option>
<option value="Hawaii">Hawaii</option>
<option value="Idaho">Idaho</option>
<option value="Illinois">Illinois</option>
<option value="Indiana">Indiana</option>
<option value="Iowa">Iowa</option>
<option value="Kansas">Kansas</option>
<option value="Kentucky">Kentucky</option>
<option value="Louisiana">Louisiana</option>
<option value="Maine">Maine</option>
<option value="Maryland">Maryland</option>
<option value="Massachusetts">Massachusetts</option>
<option value="Michigan">Michigan</option>
<option value="Minnesota">Minnesota</option>
<option value="Mississippi">Mississippi</option>
<option value="Missouri">Missouri</option>
<option value="Montana">Montana</option>
<option value="Nebraska">Nebraska</option>
<option value="Nevada">Nevada</option>
<option value="New Hampshire">New Hampshire</option>
<option value="New Jersey">New Jersey</option>
<option value="New Mexico">New Mexico</option>
<option value="New York">New York</option>
<option value="North Carolina">North Carolina</option>
<option value="North Dakota">North Dakota</option>
<option value="Ohio">Ohio</option>
<option value="Oklahoma">Oklahoma</option>
<option value="Oregon">Oregon</option>
<option value="Pennsylvania">Pennsylvania</option>
<option value="Rhode Island">Rhode Island</option>
<option value="South Carolina">South Carolina</option>
<option value="South Dakota">South Dakota</option>
<option value="Tennessee">Tennessee</option>
<option value="Texas">Texas</option>
<option value="Utah">Utah</option>
<option value="Vermont">Vermont</option>
<option value="Virginia">Virginia</option>
<option value="Washington">Washington</option>
<option value="West Virginia">West Virginia</option>
<option value="Wisconsin">Wisconsin</option>
<option value="Wyoming">Wyoming</option>
</select><label class="form-sub-label" for="input_9_state" id="sublabel_9_state" style="min-height:13px">State</label></span></span></div>
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-zip-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_9_postal" name="q9_currentAddress[postal]" class="form-textbox validate[required] form-address-postal" data-defaultvalue="" autocomplete="section-input_9 postal-code" data-component="zip"
aria-labelledby="label_9 sublabel_9_postal" required="" value="" maxlength="20"><label class="form-sub-label" for="input_9_postal" id="sublabel_9_postal" style="min-height:13px">Zip Code</label></span></span></div>
</div>
</div>
</li>
<li class="form-line jf-required" data-type="control_checkbox" id="id_98" data-css-selector="id_98"><label class="form-label form-label-top form-label-auto" id="label_98" aria-hidden="false"> Address type<span class="form-required">*</span>
</label>
<div id="cid_98" class="form-input-wide jf-required">
<div class="form-multiple-column" data-columncount="2" role="group" aria-labelledby="label_98" data-component="checkbox"><span class="form-checkbox-item"><span class="dragger-item"></span><input aria-describedby="label_98" type="checkbox"
class="form-checkbox validate[required, maxselection,minselection]" id="input_98_0" name="q98_typeA98[]" required="" data-maxselection="1" data-minselection="1" value="Business Address"><label id="label_input_98_0"
for="input_98_0">Business Address</label></span><span class="form-checkbox-item"><span class="dragger-item"></span><input aria-describedby="label_98" type="checkbox" class="form-checkbox validate[required, maxselection,minselection]"
id="input_98_1" name="q98_typeA98[]" required="" data-maxselection="1" data-minselection="1" value="Residential Address"><label id="label_input_98_1" for="input_98_1">Residential Address</label></span></div>
</div>
</li>
<li class="form-line jf-required" data-type="control_dropdown" id="id_99" data-css-selector="id_99"><label class="form-label form-label-top form-label-auto" id="label_99" for="input_99" aria-hidden="false"> Identifying document type<span
class="form-required">*</span> </label>
<div id="cid_99" class="form-input-wide jf-required"> <select class="form-dropdown validate[required]" id="input_99" name="q99_identifyingDocument" style="width:150px" data-component="dropdown" required=""
aria-label="Identifying document type">
<option value="">Please Select</option>
<option value="State-issued driver's license">State-issued driver's license</option>
<option value="State/local/tribe-issued ID">State/local/tribe-issued ID</option>
<option value="U.S. passport">U.S. passport</option>
<option value="Foreign passport">Foreign passport</option>
</select> </div>
</li>
<li class="form-line jf-required" data-type="control_textbox" id="id_100" data-css-selector="id_100"><label class="form-label form-label-top form-label-auto" id="label_100" for="input_100" aria-hidden="false"> Identifying document number<span
class="form-required">*</span> </label>
<div id="cid_100" class="form-input-wide jf-required"> <input type="text" id="input_100" name="q100_identifyingDocument100" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="20"
data-component="textbox" aria-labelledby="label_100" required="" value=""> </div>
</li>
<li class="form-line jf-required" data-type="control_textbox" id="id_103" data-css-selector="id_103"><label class="form-label form-label-top form-label-auto" id="label_103" for="input_103" aria-hidden="false"> Identifying document
jurisdiction<span class="form-required">*</span> </label>
<div id="cid_103" class="form-input-wide jf-required"> <span class="form-sub-label-container" style="vertical-align:top"><input type="text" id="input_103" name="q103_identifyingDocument103" data-type="input-textbox"
class="form-textbox validate[required]" data-defaultvalue="" size="20" data-component="textbox" aria-labelledby="label_103 sublabel_input_103" required="" value=""><label class="form-sub-label" for="input_103" id="sublabel_input_103"
style="min-height:13px">U.S. State or Country/Jurisdiction</label></span> </div>
</li>
<li class="form-line jf-required" data-type="control_fileupload" id="id_104" data-css-selector="id_104"><label class="form-label form-label-top form-label-auto" id="label_104" for="input_104" aria-hidden="false"> Identifying document image<span
class="form-required">*</span> </label>
<div id="cid_104" class="form-input-wide jf-required">
<div data-wrapper-react="true">
<div data-wrapper-react="true" class="validate[multipleUpload] validate[required]">
<div class="qq-uploader">
<div class="qq-upload-drop-area" style="display: none;"><span>Drop files here to upload</span></div>
<div class="qq-upload-button " aria-hidden="true" style="position: relative; overflow: hidden; direction: ltr;">Browse Files</div>
<div class="inputContainer" role="button" aria-label="Browse Files" tabindex="0"><input multiple="multiple" class="fileupload-input" id="input_104" type="file" name="file" aria-labelledby="label_104" aria-hidden="true" tabindex="-1">
</div><label class="form-sub-label" aria-hidden="true" for="input_104" id="sublabel_104"></label><span style="display:none" class="multipleFileUploadLabels cancelText">Cancel</span><span style="display:none"
class="multipleFileUploadLabels ofText">of</span>
<ul class="qq-upload-list" aria-label="Uploaded files"></ul>
</div>
</div><span style="display:none" class="cancelText">Cancel</span><span style="display:none" class="ofText">of</span>
</div>
</div>
</li>
<li id="cid_111" class="form-input-wide" data-type="control_pagebreak" data-css-selector="id_111">
<div class="form-pagebreak" data-component="pagebreak">
<div class="form-pagebreak-back-container"><button id="form-pagebreak-back_111" type="button" class="form-pagebreak-back form-submit-button-simple_white jf-form-buttons" data-component="pagebreak-back">Back</button></div>
<div class="form-pagebreak-next-container"><button id="form-pagebreak-next_111" type="button" class="form-pagebreak-next form-submit-button-simple_white jf-form-buttons" data-component="pagebreak-next">Next</button></div>
<div class="form-pagebreak-next-container form-pagebreak-save-container"><button id="input_scl_111" type="button" class="form-submit-button form-sacl-button js-new-sacl-button form-submit-button-simple_white jf-form-buttons sacl-button"
data-component="button" disabled="">Save</button></div>
<div style="clear:both" class="pageInfo form-sub-label" id="pageInfo_111"></div>
</div>
</li>
</ul>
<ul class="form-section page-section" style="display:none;">
<li id="cid_43" class="form-input-wide" data-type="control_head" data-css-selector="id_43">
<div class="form-header-group header-default">
<div class="header-text httal htvam">
<h2 id="header_43" class="form-header" data-component="header">Reporting Company Information</h2>
</div>
</div>
</li>
<li class="form-line jf-required" data-type="control_textbox" id="id_105" data-css-selector="id_105"><label class="form-label form-label-top form-label-auto" id="label_105" for="input_105" aria-hidden="false"> Reporting Company legal name<span
class="form-required">*</span> </label>
<div id="cid_105" class="form-input-wide jf-required"> <input type="text" id="input_105" name="q105_reportingCompany105" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="20" data-component="textbox"
aria-labelledby="label_105" required="" value=""> </div>
</li>
<li class="form-line" data-type="control_textbox" id="id_107" data-css-selector="id_107"><label class="form-label form-label-top form-label-auto" id="label_107" for="input_107" aria-hidden="false"> Alternate name (e.g. trade name, DBA) </label>
<div id="cid_107" class="form-input-wide"> <input type="text" id="input_107" name="q107_typeA107" data-type="input-textbox" class="form-textbox" data-defaultvalue="" size="20" data-component="textbox" aria-labelledby="label_107" value="">
</div>
</li>
<li class="form-line jf-required" data-type="control_dropdown" id="id_108" data-css-selector="id_108"><label class="form-label form-label-top form-label-auto" id="label_108" for="input_108" aria-hidden="false"> Tax Identification type<span
class="form-required">*</span> </label>
<div id="cid_108" class="form-input-wide jf-required"> <select class="form-dropdown validate[required]" id="input_108" name="q108_typeA108" style="width:150px" data-component="dropdown" required="" aria-label="Tax Identification type">
<option value="">Please Select</option>
<option value="EIN">EIN</option>
<option value="SSN/ITIN">SSN/ITIN</option>
<option value="Foreign">Foreign</option>
</select> </div>
</li>
<li class="form-line jf-required" data-type="control_textbox" id="id_189" data-css-selector="id_189"><label class="form-label form-label-top form-label-auto" id="label_189" for="input_189" aria-hidden="false"> Tax identification number<span
class="form-required">*</span> </label>
<div id="cid_189" class="form-input-wide jf-required"> <input type="text" id="input_189" name="q189_taxIdentification" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="20" data-component="textbox"
aria-labelledby="label_189" required="" value=""> </div>
</li>
<li class="form-line" data-type="control_textbox" id="id_109" data-css-selector="id_109"><label class="form-label form-label-top form-label-auto" id="label_109" for="input_109" aria-hidden="false"> Country/Jurisdiction (if Foreign Tax ID)
</label>
<div id="cid_109" class="form-input-wide"> <input type="text" id="input_109" name="q109_countryjurisdictionif" data-type="input-textbox" class="form-textbox" data-defaultvalue="" size="20" data-component="textbox" aria-labelledby="label_109"
value=""> </div>
</li>
<li class="form-line jf-required" data-type="control_address" id="id_46" data-css-selector="id_46"><label class="form-label form-label-top form-label-auto" id="label_46" for="input_46_addr_line1" aria-hidden="false"> Current US Address<span
class="form-required">*</span> </label>
<div id="cid_46" class="form-input-wide jf-required">
<div summary="" class="form-address-table jsTest-addressField">
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-street-line jsTest-address-lineField"><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_46_addr_line1" name="q46_address46[addr_line1]" class="form-textbox validate[required] form-address-line" data-defaultvalue="" autocomplete="section-input_46 address-line1" data-component="address_line_1"
aria-labelledby="label_46 sublabel_46_addr_line1" required="" value="" maxlength="100"><label class="form-sub-label" for="input_46_addr_line1" id="sublabel_46_addr_line1" style="min-height:13px">Street
Address</label></span></span></div>
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-street-line jsTest-address-lineField"><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_46_addr_line2" name="q46_address46[addr_line2]" class="form-textbox form-address-line" data-defaultvalue="" autocomplete="section-input_46 address-line2" data-component="address_line_2"
aria-labelledby="label_46 sublabel_46_addr_line2" value="" maxlength="100"><label class="form-sub-label" for="input_46_addr_line2" id="sublabel_46_addr_line2" style="min-height:13px">Street Address Line 2</label></span></span>
</div>
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-city-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_46_city" name="q46_address46[city]" class="form-textbox validate[required] form-address-city" data-defaultvalue="" autocomplete="section-input_46 address-level2" data-component="city"
aria-labelledby="label_46 sublabel_46_city" required="" value="" maxlength="60"><label class="form-sub-label" for="input_46_city" id="sublabel_46_city" style="min-height:13px">City</label></span></span><span
class="form-address-line form-address-state-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><select class="form-dropdown validate[required] form-address-state"
name="q46_address46[state]" id="input_46_state" data-component="state" required="" aria-labelledby="label_46 sublabel_46_state" autocomplete="section-input_46 address-level1">
<option value="" selected="">Please Select</option>
<option value="Alabama">Alabama</option>
<option value="Alaska">Alaska</option>
<option value="Arizona">Arizona</option>
<option value="Arkansas">Arkansas</option>
<option value="California">California</option>
<option value="Colorado">Colorado</option>
<option value="Connecticut">Connecticut</option>
<option value="Delaware">Delaware</option>
<option value="District of Columbia">District of Columbia</option>
<option value="Florida">Florida</option>
<option value="Georgia">Georgia</option>
<option value="Hawaii">Hawaii</option>
<option value="Idaho">Idaho</option>
<option value="Illinois">Illinois</option>
<option value="Indiana">Indiana</option>
<option value="Iowa">Iowa</option>
<option value="Kansas">Kansas</option>
<option value="Kentucky">Kentucky</option>
<option value="Louisiana">Louisiana</option>
<option value="Maine">Maine</option>
<option value="Maryland">Maryland</option>
<option value="Massachusetts">Massachusetts</option>
<option value="Michigan">Michigan</option>
<option value="Minnesota">Minnesota</option>
<option value="Mississippi">Mississippi</option>
<option value="Missouri">Missouri</option>
<option value="Montana">Montana</option>
<option value="Nebraska">Nebraska</option>
<option value="Nevada">Nevada</option>
<option value="New Hampshire">New Hampshire</option>
<option value="New Jersey">New Jersey</option>
<option value="New Mexico">New Mexico</option>
<option value="New York">New York</option>
<option value="North Carolina">North Carolina</option>
<option value="North Dakota">North Dakota</option>
<option value="Ohio">Ohio</option>
<option value="Oklahoma">Oklahoma</option>
<option value="Oregon">Oregon</option>
<option value="Pennsylvania">Pennsylvania</option>
<option value="Rhode Island">Rhode Island</option>
<option value="South Carolina">South Carolina</option>
<option value="South Dakota">South Dakota</option>
<option value="Tennessee">Tennessee</option>
<option value="Texas">Texas</option>
<option value="Utah">Utah</option>
<option value="Vermont">Vermont</option>
<option value="Virginia">Virginia</option>
<option value="Washington">Washington</option>
<option value="West Virginia">West Virginia</option>
<option value="Wisconsin">Wisconsin</option>
<option value="Wyoming">Wyoming</option>
</select><label class="form-sub-label" for="input_46_state" id="sublabel_46_state" style="min-height:13px">State</label></span></span></div>
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-zip-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_46_postal" name="q46_address46[postal]" class="form-textbox validate[required] form-address-postal" data-defaultvalue="" autocomplete="section-input_46 postal-code" data-component="zip"
aria-labelledby="label_46 sublabel_46_postal" required="" value="" maxlength="20"><label class="form-sub-label" for="input_46_postal" id="sublabel_46_postal" style="min-height:13px">Zip Code</label></span></span></div>
</div>
</div>
</li>
<li class="form-line" data-type="control_divider" id="id_26" data-css-selector="id_26">
<div id="cid_26" class="form-input-wide">
<div class="divider" data-component="divider" style="border-bottom-width:1px;border-bottom-style:solid;border-color:#e6e6e6;height:1px;margin-left:0px;margin-right:0px;margin-top:5px;margin-bottom:5px"></div>
</div>
</li>
<li class="form-line always-hidden" data-type="control_number" id="id_187" data-css-selector="id_187"><label class="form-label form-label-top form-label-auto" id="label_187" for="input_187" aria-hidden="false"> Benowner jump Number </label>
<div id="cid_187" class="form-input-wide always-hidden"> <input type="number" id="input_187" name="q187_benownerJump" data-type="input-number" class=" form-number-input form-textbox" data-defaultvalue="" style="width:60px" size="5"
placeholder="e.g., 23" data-component="number" aria-labelledby="label_187" step="any" value=""> </div>
</li>
<li id="cid_106" class="form-input-wide" data-type="control_pagebreak" data-css-selector="id_106">
<div class="form-pagebreak" data-component="pagebreak">
<div class="form-pagebreak-back-container"><button id="form-pagebreak-back_106" type="button" class="form-pagebreak-back jf-form-buttons" data-component="pagebreak-back">Back</button></div>
<div class="form-pagebreak-next-container"><button id="form-pagebreak-next_106" type="button" class="form-pagebreak-next jf-form-buttons" data-component="pagebreak-next">Next</button></div>
<div class="form-pagebreak-next-container form-pagebreak-save-container"><button id="input_scl_106" type="button" class="form-submit-button form-sacl-button js-new-sacl-button jf-form-buttons sacl-button" data-component="button"
disabled="">Save</button></div>
<div style="clear:both" class="pageInfo form-sub-label" id="pageInfo_106"></div>
</div>
</li>
</ul>
<ul class="form-section page-section" style="display:none;">
<li id="cid_122" class="form-input-wide" data-type="control_head" data-css-selector="id_122">
<div class="form-header-group header-default">
<div class="header-text httal htvam">
<h2 id="header_122" class="form-header" data-component="header">Woah there!</h2>
<div id="subHeader_122" class="form-subHeader">Let's go ahead and catch up on a call</div>
</div>
</div>
</li>
<li class="form-line" data-type="control_text" id="id_124" data-css-selector="id_124">
<div id="cid_124" class="form-input-wide">
<div id="text_124" class="form-html" data-component="text" tabindex="0">
<h2>Let's take the time to get this right</h2>
<p>We are working to build the simplest, most straight forward BOI Reporting tool out there. </p>
<p>Your answer of >5 beneficial owners makes us think that we might be better served to have a quick conversation before we file this form.</p>
<p>We want to get it right!</p>
<p>Your consult fee will go to the cost of preparing the form. We will make this quick and easy for you!</p>
</div>
</div>
</li>
<li class="form-line" data-type="control_widget" id="id_123" data-css-selector="id_123"><label class="form-label form-label-top form-label-auto" id="label_123" for="input_123" aria-hidden="true"> </label>
<div id="cid_123" class="form-input-wide">
<div data-widget-name="Calendly" style="width:100%;text-align:Left;overflow-x:auto" data-component="widget-field"><iframe data-client-id="b83739743814bf0ed1503bde" title="Calendly" frameborder="0" scrolling="no" allowtransparency="true"
allow="geolocation; microphone; camera; autoplay; encrypted-media; fullscreen" data-type="iframe" class="custom-field-frame custom-field-frame-rendered frame-xd-ready" id="customFieldFrame_123"
src="https://www.jotform.com/form-widgets/calendly/?qid=123&isOpenedInPortal=undefined&isOpenedInAgent=undefined&align=Left&ref=https%3A%2F%2Fform.jotform.com&injectCSS=false"
style="max-width:650px;border:none;width:100%;height:600px" data-width="650" data-height="600"></iframe>
<div class="widget-inputs-wrapper"><input id="input_123" class="form-hidden form-widget " type="hidden" name="q123_input123" value=""><input id="widget_settings_123" class="form-hidden form-widget-settings" type="hidden" data-version="2"
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<li id="cid_117" class="form-input-wide" data-type="control_pagebreak" data-css-selector="id_117">
<div class="form-pagebreak" data-component="pagebreak">
<div class="form-pagebreak-back-container"><button id="form-pagebreak-back_117" type="button" class="form-pagebreak-back form-submit-button-simple_white jf-form-buttons" data-component="pagebreak-back">Back</button></div>
<div class="form-pagebreak-next-container"><button id="form-pagebreak-next_117" type="button" class="form-pagebreak-next form-submit-button-simple_white jf-form-buttons" data-component="pagebreak-next">Next</button></div>
<div class="form-pagebreak-next-container form-pagebreak-save-container"><button id="input_scl_117" type="button" class="form-submit-button form-sacl-button js-new-sacl-button form-submit-button-simple_white jf-form-buttons sacl-button"
data-component="button" disabled="">Save</button></div>
<div style="clear:both" class="pageInfo form-sub-label" id="pageInfo_117"></div>
</div>
</li>
</ul>
<ul class="form-section page-section" style="display:none;">
<li id="cid_118" class="form-input-wide" data-type="control_head" data-css-selector="id_118">
<div class="form-header-group header-default">
<div class="header-text httal htvam">
<h2 id="header_118" class="form-header" data-component="header">Beneficial Owner(s) Information</h2>
</div>
</div>
</li>
<li class="form-line jf-required" data-type="control_textbox" id="id_125" data-css-selector="id_125"><label class="form-label form-label-top form-label-auto" id="label_125" for="input_125" aria-hidden="false"> Entity Name, or Individual's last
name<span class="form-required">*</span> </label>
<div id="cid_125" class="form-input-wide jf-required"> <input type="text" id="input_125" name="q125_entityName" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="20" data-component="textbox"
aria-labelledby="label_125" required="" value=""> </div>
</li>
<li class="form-line" data-type="control_textbox" id="id_126" data-css-selector="id_126"><label class="form-label form-label-top form-label-auto" id="label_126" for="input_126" aria-hidden="false"> First name </label>
<div id="cid_126" class="form-input-wide"> <input type="text" id="input_126" name="q126_firstName" data-type="input-textbox" class="form-textbox" data-defaultvalue="" size="20" data-component="textbox" aria-labelledby="label_126" value="">
</div>
</li>
<li class="form-line" data-type="control_textbox" id="id_127" data-css-selector="id_127"><label class="form-label form-label-top form-label-auto" id="label_127" for="input_127" aria-hidden="false"> Middle Name </label>
<div id="cid_127" class="form-input-wide"> <input type="text" id="input_127" name="q127_middleName" data-type="input-textbox" class="form-textbox" data-defaultvalue="" size="20" data-component="textbox" aria-labelledby="label_127" value="">
</div>
</li>
<li class="form-line jf-required" data-type="control_datetime" id="id_128" data-css-selector="id_128"><label class="form-label form-label-top form-label-auto" id="label_128" for="lite_mode_128" aria-hidden="false"> Date of Birth or Entity
Registration<span class="form-required">*</span> </label>
<div id="cid_128" class="form-input-wide jf-required">
<div data-wrapper-react="true">
<div style="display:none"><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[required, limitDate]" id="month_128" name="q128_dateOf128[month]" type="tel" size="2" data-maxlength="2"
data-age="" maxlength="2" required="" autocomplete="off" aria-labelledby="label_128 sublabel_128_month" value=""><span class="date-separate" aria-hidden="true"> -</span><label class="form-sub-label" for="month_128"
id="sublabel_128_month" style="min-height:13px">Month</label></span><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[required, limitDate]" id="day_128" name="q128_dateOf128[day]"
type="tel" size="2" data-maxlength="2" data-age="" maxlength="2" required="" autocomplete="off" aria-labelledby="label_128 sublabel_128_day" value=""><span class="date-separate" aria-hidden="true"> -</span><label
class="form-sub-label" for="day_128" id="sublabel_128_day" style="min-height:13px">Day</label></span><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[required, limitDate]"
id="year_128" name="q128_dateOf128[year]" type="tel" size="4" data-maxlength="4" data-age="" maxlength="4" required="" autocomplete="off" aria-labelledby="label_128 sublabel_128_year" value=""><label class="form-sub-label"
for="year_128" id="sublabel_128_year" style="min-height:13px">Year</label></span></div><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[required, limitDate, validateLiteDate]"
id="lite_mode_128" type="text" size="12" data-maxlength="12" maxlength="12" data-age="" required="" data-format="mmddyyyy" data-seperator="-" placeholder="mm-dd-yyyy" data-placeholder="MM-DD-YYYY" autocomplete="off"
aria-labelledby="label_128 sublabel_128_litemode" value=""><img class=" newDefaultTheme-dateIcon icon-liteMode" alt="Pick a Date" id="input_128_pick" src="https://cdn.jotfor.ms/images/calendar.png" data-component="datetime"
aria-hidden="false" data-allow-time="No" data-version="v1" aria-label="Choose Date" role="button" tabindex="0" aria-haspopup="dialog" aria-expanded="false"><label class="form-sub-label" for="lite_mode_128" id="sublabel_128_litemode"
style="min-height:13px">Date</label></span>
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<li class="form-line jf-required" data-type="control_address" id="id_129" data-compound-hint=",,,,Please Select,,Please Select," data-css-selector="id_129"><label class="form-label form-label-top form-label-auto" id="label_129"
for="input_129_addr_line1" aria-hidden="false"> Residential address<span class="form-required">*</span> </label>
<div id="cid_129" class="form-input-wide jf-required">
<div summary="" class="form-address-table jsTest-addressField">
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-street-line jsTest-address-lineField"><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_129_addr_line1" name="q129_residentialAddress[addr_line1]" class="form-textbox validate[required] form-address-line" data-defaultvalue="" autocomplete="section-input_129 address-line1" data-component="address_line_1"
aria-labelledby="label_129 sublabel_129_addr_line1" required="" value="" maxlength="100"><label class="form-sub-label" for="input_129_addr_line1" id="sublabel_129_addr_line1" style="min-height:13px">Street
Address</label></span></span></div>
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-street-line jsTest-address-lineField"><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_129_addr_line2" name="q129_residentialAddress[addr_line2]" class="form-textbox form-address-line" data-defaultvalue="" autocomplete="section-input_129 address-line2" data-component="address_line_2"
aria-labelledby="label_129 sublabel_129_addr_line2" value="" maxlength="100"><label class="form-sub-label" for="input_129_addr_line2" id="sublabel_129_addr_line2" style="min-height:13px">Street Address Line 2</label></span></span>
</div>
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-city-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_129_city" name="q129_residentialAddress[city]" class="form-textbox validate[required] form-address-city" data-defaultvalue="" autocomplete="section-input_129 address-level2" data-component="city"
aria-labelledby="label_129 sublabel_129_city" required="" value="" maxlength="60"><label class="form-sub-label" for="input_129_city" id="sublabel_129_city" style="min-height:13px">City</label></span></span><span
class="form-address-line form-address-state-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><input type="text" id="input_129_state" name="q129_residentialAddress[state]"
class="form-textbox validate[required] form-address-state" data-defaultvalue="" autocomplete="section-input_129 address-level1" data-component="state" aria-labelledby="label_129 sublabel_129_state" required="" value=""
maxlength="60"><label class="form-sub-label" for="input_129_state" id="sublabel_129_state" style="min-height:13px">State / Province</label></span></span></div>
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-zip-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_129_postal" name="q129_residentialAddress[postal]" class="form-textbox validate[required] form-address-postal" data-defaultvalue="" autocomplete="section-input_129 postal-code" data-component="zip"
aria-labelledby="label_129 sublabel_129_postal" required="" value="" maxlength="20"><label class="form-sub-label" for="input_129_postal" id="sublabel_129_postal" style="min-height:13px">Postal / Zip Code</label></span></span>
</div>
</div>
</div>
</li>
<li class="form-line jf-required" data-type="control_dropdown" id="id_130" data-css-selector="id_130"><label class="form-label form-label-top form-label-auto" id="label_130" for="input_130" aria-hidden="false"> Identifying document type<span
class="form-required">*</span> </label>
<div id="cid_130" class="form-input-wide jf-required"> <select class="form-dropdown validate[required]" id="input_130" name="q130_identifyingDocument130" style="width:150px" data-component="dropdown" required=""
aria-label="Identifying document type">
<option value="">Please Select</option>
<option value="State-issued driver's license">State-issued driver's license</option>
<option value="State/local/tribe-issued ID">State/local/tribe-issued ID</option>
<option value="U.S. passport">U.S. passport</option>
<option value="Foreign passport">Foreign passport</option>
</select> </div>
</li>
<li class="form-line jf-required" data-type="control_textbox" id="id_131" data-css-selector="id_131"><label class="form-label form-label-top form-label-auto" id="label_131" for="input_131" aria-hidden="false"> Identifying document number<span
class="form-required">*</span> </label>
<div id="cid_131" class="form-input-wide jf-required"> <input type="text" id="input_131" name="q131_identifyingDocument131" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="20"
data-component="textbox" aria-labelledby="label_131" required="" value=""> </div>
</li>
<li class="form-line jf-required" data-type="control_textbox" id="id_132" data-css-selector="id_132"><label class="form-label form-label-top form-label-auto" id="label_132" for="input_132" aria-hidden="false"> Identifying document
jurisdiction<span class="form-required">*</span> </label>
<div id="cid_132" class="form-input-wide jf-required"> <span class="form-sub-label-container" style="vertical-align:top"><input type="text" id="input_132" name="q132_identifyingDocument132" data-type="input-textbox"
class="form-textbox validate[required]" data-defaultvalue="" size="20" data-component="textbox" aria-labelledby="label_132 sublabel_input_132" required="" value=""><label class="form-sub-label" for="input_132" id="sublabel_input_132"
style="min-height:13px">U.S. State or Country/Jurisdiction</label></span> </div>
</li>
<li class="form-line jf-required" data-type="control_fileupload" id="id_133" data-css-selector="id_133"><label class="form-label form-label-top form-label-auto" id="label_133" for="input_133" aria-hidden="false"> Identifying document image<span
class="form-required">*</span> </label>
<div id="cid_133" class="form-input-wide jf-required">
<div data-wrapper-react="true">
<div data-wrapper-react="true" class="validate[multipleUpload] validate[required]">
<div class="qq-uploader">
<div class="qq-upload-drop-area" style="display: none;"><span>Drop files here to upload</span></div>
<div class="qq-upload-button " aria-hidden="true" style="position: relative; overflow: hidden; direction: ltr;">Browse Files</div>
<div class="inputContainer" role="button" aria-label="Browse Files" tabindex="0"><input multiple="multiple" class="fileupload-input" id="input_133" type="file" name="file" aria-labelledby="label_133" aria-hidden="true" tabindex="-1">
</div><label class="form-sub-label" aria-hidden="true" for="input_133" id="sublabel_133"></label><span style="display:none" class="multipleFileUploadLabels cancelText">Cancel</span><span style="display:none"
class="multipleFileUploadLabels ofText">of</span>
<ul class="qq-upload-list" aria-label="Uploaded files"></ul>
</div>
</div><span style="display:none" class="cancelText">Cancel</span><span style="display:none" class="ofText">of</span>
</div>
</div>
</li>
<li class="form-line" data-type="control_radio" id="id_120" data-css-selector="id_120"><label class="form-label form-label-top form-label-auto" id="label_120" for="input_120_0" aria-hidden="false"> Are you a Parent/Guardian applying for a
minor? </label>
<div id="cid_120" class="form-input-wide">
<div class="form-single-column" role="group" aria-labelledby="label_120" data-component="radio"><span class="form-radio-item" style="clear:left"><span class="dragger-item"></span><input aria-describedby="label_120" type="radio"
class="form-radio" id="input_120_0" name="q120_areYou" value="Check if yes"><label id="label_input_120_0" for="input_120_0">Check if yes</label></span></div>
</div>
</li>
<li id="cid_145" class="form-input-wide" data-type="control_pagebreak" data-css-selector="id_145">
<div class="form-pagebreak" data-component="pagebreak">
<div class="form-pagebreak-back-container"><button id="form-pagebreak-back_145" type="button" class="form-pagebreak-back jf-form-buttons" data-component="pagebreak-back">Back</button></div>
<div class="form-pagebreak-next-container"><button id="form-pagebreak-next_145" type="button" class="form-pagebreak-next button-hidden jf-form-buttons" data-component="pagebreak-next">Next</button></div>
<div class="form-pagebreak-next-container form-pagebreak-save-container"><button id="input_scl_145" type="button" class="form-submit-button form-sacl-button js-new-sacl-button jf-form-buttons sacl-button" data-component="button"
disabled="">Save</button></div>
<div style="clear:both" class="pageInfo form-sub-label" id="pageInfo_145"></div>
</div>
</li>
</ul>
<ul class="form-section page-section" style="display:none;">
<li id="cid_134" class="form-input-wide" data-type="control_head" data-css-selector="id_134">
<div class="form-header-group header-default">
<div class="header-text httal htvam">
<h2 id="header_134" class="form-header" data-component="header">Beneficial Owner(s) Information</h2>
</div>
</div>
</li>
<li class="form-line jf-required" data-type="control_textbox" id="id_135" data-css-selector="id_135"><label class="form-label form-label-top form-label-auto" id="label_135" for="input_135" aria-hidden="false"> Entity Name, or Individual's last
name<span class="form-required">*</span> </label>
<div id="cid_135" class="form-input-wide jf-required"> <input type="text" id="input_135" name="q135_entityName135" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="20" data-component="textbox"
aria-labelledby="label_135" required="" value=""> </div>
</li>
<li class="form-line" data-type="control_textbox" id="id_136" data-css-selector="id_136"><label class="form-label form-label-top form-label-auto" id="label_136" for="input_136" aria-hidden="false"> First name </label>
<div id="cid_136" class="form-input-wide"> <input type="text" id="input_136" name="q136_firstName136" data-type="input-textbox" class="form-textbox" data-defaultvalue="" size="20" data-component="textbox" aria-labelledby="label_136" value="">
</div>
</li>
<li class="form-line" data-type="control_textbox" id="id_137" data-css-selector="id_137"><label class="form-label form-label-top form-label-auto" id="label_137" for="input_137" aria-hidden="false"> Middle Name </label>
<div id="cid_137" class="form-input-wide"> <input type="text" id="input_137" name="q137_middleName137" data-type="input-textbox" class="form-textbox" data-defaultvalue="" size="20" data-component="textbox" aria-labelledby="label_137"
value=""> </div>
</li>
<li class="form-line jf-required" data-type="control_datetime" id="id_138" data-css-selector="id_138"><label class="form-label form-label-top form-label-auto" id="label_138" for="lite_mode_138" aria-hidden="false"> Date of Birth or Entity
Registration<span class="form-required">*</span> </label>
<div id="cid_138" class="form-input-wide jf-required">
<div data-wrapper-react="true">
<div style="display:none"><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[required, limitDate]" id="month_138" name="q138_dateOf138[month]" type="tel" size="2" data-maxlength="2"
data-age="" maxlength="2" required="" autocomplete="off" aria-labelledby="label_138 sublabel_138_month" value=""><span class="date-separate" aria-hidden="true"> -</span><label class="form-sub-label" for="month_138"
id="sublabel_138_month" style="min-height:13px">Month</label></span><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[required, limitDate]" id="day_138" name="q138_dateOf138[day]"
type="tel" size="2" data-maxlength="2" data-age="" maxlength="2" required="" autocomplete="off" aria-labelledby="label_138 sublabel_138_day" value=""><span class="date-separate" aria-hidden="true"> -</span><label
class="form-sub-label" for="day_138" id="sublabel_138_day" style="min-height:13px">Day</label></span><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[required, limitDate]"
id="year_138" name="q138_dateOf138[year]" type="tel" size="4" data-maxlength="4" data-age="" maxlength="4" required="" autocomplete="off" aria-labelledby="label_138 sublabel_138_year" value=""><label class="form-sub-label"
for="year_138" id="sublabel_138_year" style="min-height:13px">Year</label></span></div><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[required, limitDate, validateLiteDate]"
id="lite_mode_138" type="text" size="12" data-maxlength="12" maxlength="12" data-age="" required="" data-format="mmddyyyy" data-seperator="-" placeholder="mm-dd-yyyy" data-placeholder="MM-DD-YYYY" autocomplete="off"
aria-labelledby="label_138 sublabel_138_litemode" value=""><img class=" newDefaultTheme-dateIcon icon-liteMode" alt="Pick a Date" id="input_138_pick" src="https://cdn.jotfor.ms/images/calendar.png" data-component="datetime"
aria-hidden="false" data-allow-time="No" data-version="v1" aria-label="Choose Date" role="button" tabindex="0" aria-haspopup="dialog" aria-expanded="false"><label class="form-sub-label" for="lite_mode_138" id="sublabel_138_litemode"
style="min-height:13px">Date</label></span>
</div>
</div>
</li>
<li class="form-line jf-required" data-type="control_address" id="id_139" data-compound-hint=",,,,Please Select,,Please Select," data-css-selector="id_139"><label class="form-label form-label-top form-label-auto" id="label_139"
for="input_139_addr_line1" aria-hidden="false"> Residential address<span class="form-required">*</span> </label>
<div id="cid_139" class="form-input-wide jf-required">
<div summary="" class="form-address-table jsTest-addressField">
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-street-line jsTest-address-lineField"><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_139_addr_line1" name="q139_residentialAddress139[addr_line1]" class="form-textbox validate[required] form-address-line" data-defaultvalue="" autocomplete="section-input_139 address-line1" data-component="address_line_1"
aria-labelledby="label_139 sublabel_139_addr_line1" required="" value="" maxlength="100"><label class="form-sub-label" for="input_139_addr_line1" id="sublabel_139_addr_line1" style="min-height:13px">Street
Address</label></span></span></div>
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-street-line jsTest-address-lineField"><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_139_addr_line2" name="q139_residentialAddress139[addr_line2]" class="form-textbox form-address-line" data-defaultvalue="" autocomplete="section-input_139 address-line2" data-component="address_line_2"
aria-labelledby="label_139 sublabel_139_addr_line2" value="" maxlength="100"><label class="form-sub-label" for="input_139_addr_line2" id="sublabel_139_addr_line2" style="min-height:13px">Street Address Line 2</label></span></span>
</div>
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-city-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_139_city" name="q139_residentialAddress139[city]" class="form-textbox validate[required] form-address-city" data-defaultvalue="" autocomplete="section-input_139 address-level2" data-component="city"
aria-labelledby="label_139 sublabel_139_city" required="" value="" maxlength="60"><label class="form-sub-label" for="input_139_city" id="sublabel_139_city" style="min-height:13px">City</label></span></span><span
class="form-address-line form-address-state-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><input type="text" id="input_139_state" name="q139_residentialAddress139[state]"
class="form-textbox validate[required] form-address-state" data-defaultvalue="" autocomplete="section-input_139 address-level1" data-component="state" aria-labelledby="label_139 sublabel_139_state" required="" value=""
maxlength="60"><label class="form-sub-label" for="input_139_state" id="sublabel_139_state" style="min-height:13px">State / Province</label></span></span></div>
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-zip-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_139_postal" name="q139_residentialAddress139[postal]" class="form-textbox validate[required] form-address-postal" data-defaultvalue="" autocomplete="section-input_139 postal-code" data-component="zip"
aria-labelledby="label_139 sublabel_139_postal" required="" value="" maxlength="20"><label class="form-sub-label" for="input_139_postal" id="sublabel_139_postal" style="min-height:13px">Postal / Zip Code</label></span></span>
</div>
</div>
</div>
</li>
<li class="form-line jf-required" data-type="control_dropdown" id="id_140" data-css-selector="id_140"><label class="form-label form-label-top form-label-auto" id="label_140" for="input_140" aria-hidden="false"> Identifying document type<span
class="form-required">*</span> </label>
<div id="cid_140" class="form-input-wide jf-required"> <select class="form-dropdown validate[required]" id="input_140" name="q140_identifyingDocument140" style="width:150px" data-component="dropdown" required=""
aria-label="Identifying document type">
<option value="">Please Select</option>
<option value="State-issued driver's license">State-issued driver's license</option>
<option value="State/local/tribe-issued ID">State/local/tribe-issued ID</option>
<option value="U.S. passport">U.S. passport</option>
<option value="Foreign passport">Foreign passport</option>
</select> </div>
</li>
<li class="form-line jf-required" data-type="control_textbox" id="id_141" data-css-selector="id_141"><label class="form-label form-label-top form-label-auto" id="label_141" for="input_141" aria-hidden="false"> Identifying document number<span
class="form-required">*</span> </label>
<div id="cid_141" class="form-input-wide jf-required"> <input type="text" id="input_141" name="q141_identifyingDocument141" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="20"
data-component="textbox" aria-labelledby="label_141" required="" value=""> </div>
</li>
<li class="form-line jf-required" data-type="control_textbox" id="id_142" data-css-selector="id_142"><label class="form-label form-label-top form-label-auto" id="label_142" for="input_142" aria-hidden="false"> Identifying document
jurisdiction<span class="form-required">*</span> </label>
<div id="cid_142" class="form-input-wide jf-required"> <span class="form-sub-label-container" style="vertical-align:top"><input type="text" id="input_142" name="q142_identifyingDocument142" data-type="input-textbox"
class="form-textbox validate[required]" data-defaultvalue="" size="20" data-component="textbox" aria-labelledby="label_142 sublabel_input_142" required="" value=""><label class="form-sub-label" for="input_142" id="sublabel_input_142"
style="min-height:13px">U.S. State or Country/Jurisdiction</label></span> </div>
</li>
<li class="form-line jf-required" data-type="control_fileupload" id="id_143" data-css-selector="id_143"><label class="form-label form-label-top form-label-auto" id="label_143" for="input_143" aria-hidden="false"> Identifying document image<span
class="form-required">*</span> </label>
<div id="cid_143" class="form-input-wide jf-required">
<div data-wrapper-react="true">
<div data-wrapper-react="true" class="validate[multipleUpload] validate[required]">
<div class="qq-uploader">
<div class="qq-upload-drop-area" style="display: none;"><span>Drop files here to upload</span></div>
<div class="qq-upload-button " aria-hidden="true" style="position: relative; overflow: hidden; direction: ltr;">Browse Files</div>
<div class="inputContainer" role="button" aria-label="Browse Files" tabindex="0"><input multiple="multiple" class="fileupload-input" id="input_143" type="file" name="file" aria-labelledby="label_143" aria-hidden="true" tabindex="-1">
</div><label class="form-sub-label" aria-hidden="true" for="input_143" id="sublabel_143"></label><span style="display:none" class="multipleFileUploadLabels cancelText">Cancel</span><span style="display:none"
class="multipleFileUploadLabels ofText">of</span>
<ul class="qq-upload-list" aria-label="Uploaded files"></ul>
</div>
</div><span style="display:none" class="cancelText">Cancel</span><span style="display:none" class="ofText">of</span>
</div>
</div>
</li>
<li class="form-line" data-type="control_radio" id="id_144" data-css-selector="id_144"><label class="form-label form-label-top form-label-auto" id="label_144" for="input_144_0" aria-hidden="false"> Are you a Parent/Guardian applying for a
minor? </label>
<div id="cid_144" class="form-input-wide">
<div class="form-single-column" role="group" aria-labelledby="label_144" data-component="radio"><span class="form-radio-item" style="clear:left"><span class="dragger-item"></span><input aria-describedby="label_144" type="radio"
class="form-radio" id="input_144_0" name="q144_areYou144" value="Check if yes"><label id="label_input_144_0" for="input_144_0">Check if yes</label></span></div>
</div>
</li>
<li id="cid_146" class="form-input-wide" data-type="control_pagebreak" data-css-selector="id_146">
<div class="form-pagebreak" data-component="pagebreak">
<div class="form-pagebreak-back-container"><button id="form-pagebreak-back_146" type="button" class="form-pagebreak-back jf-form-buttons" data-component="pagebreak-back">Back</button></div>
<div class="form-pagebreak-next-container"><button id="form-pagebreak-next_146" type="button" class="form-pagebreak-next jf-form-buttons" data-component="pagebreak-next">Next</button></div>
<div class="form-pagebreak-next-container form-pagebreak-save-container"><button id="input_scl_146" type="button" class="form-submit-button form-sacl-button js-new-sacl-button jf-form-buttons sacl-button" data-component="button"
disabled="">Save</button></div>
<div style="clear:both" class="pageInfo form-sub-label" id="pageInfo_146"></div>
</div>
</li>
</ul>
<ul class="form-section page-section" style="display:none;">
<li id="cid_147" class="form-input-wide" data-type="control_head" data-css-selector="id_147">
<div class="form-header-group header-default">
<div class="header-text httal htvam">
<h2 id="header_147" class="form-header" data-component="header">Beneficial Owner(s) Information</h2>
</div>
</div>
</li>
<li class="form-line jf-required" data-type="control_textbox" id="id_148" data-css-selector="id_148"><label class="form-label form-label-top form-label-auto" id="label_148" for="input_148" aria-hidden="false"> Entity Name, or Individual's last
name<span class="form-required">*</span> </label>
<div id="cid_148" class="form-input-wide jf-required"> <input type="text" id="input_148" name="q148_entityName148" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="20" data-component="textbox"
aria-labelledby="label_148" required="" value=""> </div>
</li>
<li class="form-line" data-type="control_textbox" id="id_149" data-css-selector="id_149"><label class="form-label form-label-top form-label-auto" id="label_149" for="input_149" aria-hidden="false"> First name </label>
<div id="cid_149" class="form-input-wide"> <input type="text" id="input_149" name="q149_firstName149" data-type="input-textbox" class="form-textbox" data-defaultvalue="" size="20" data-component="textbox" aria-labelledby="label_149" value="">
</div>
</li>
<li class="form-line" data-type="control_textbox" id="id_150" data-css-selector="id_150"><label class="form-label form-label-top form-label-auto" id="label_150" for="input_150" aria-hidden="false"> Middle Name </label>
<div id="cid_150" class="form-input-wide"> <input type="text" id="input_150" name="q150_middleName150" data-type="input-textbox" class="form-textbox" data-defaultvalue="" size="20" data-component="textbox" aria-labelledby="label_150"
value=""> </div>
</li>
<li class="form-line jf-required" data-type="control_datetime" id="id_151" data-css-selector="id_151"><label class="form-label form-label-top form-label-auto" id="label_151" for="lite_mode_151" aria-hidden="false"> Date of Birth or Entity
Registration<span class="form-required">*</span> </label>
<div id="cid_151" class="form-input-wide jf-required">
<div data-wrapper-react="true">
<div style="display:none"><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[required, limitDate]" id="month_151" name="q151_dateOf151[month]" type="tel" size="2" data-maxlength="2"
data-age="" maxlength="2" required="" autocomplete="off" aria-labelledby="label_151 sublabel_151_month" value=""><span class="date-separate" aria-hidden="true"> -</span><label class="form-sub-label" for="month_151"
id="sublabel_151_month" style="min-height:13px">Month</label></span><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[required, limitDate]" id="day_151" name="q151_dateOf151[day]"
type="tel" size="2" data-maxlength="2" data-age="" maxlength="2" required="" autocomplete="off" aria-labelledby="label_151 sublabel_151_day" value=""><span class="date-separate" aria-hidden="true"> -</span><label
class="form-sub-label" for="day_151" id="sublabel_151_day" style="min-height:13px">Day</label></span><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[required, limitDate]"
id="year_151" name="q151_dateOf151[year]" type="tel" size="4" data-maxlength="4" data-age="" maxlength="4" required="" autocomplete="off" aria-labelledby="label_151 sublabel_151_year" value=""><label class="form-sub-label"
for="year_151" id="sublabel_151_year" style="min-height:13px">Year</label></span></div><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[required, limitDate, validateLiteDate]"
id="lite_mode_151" type="text" size="12" data-maxlength="12" maxlength="12" data-age="" required="" data-format="mmddyyyy" data-seperator="-" placeholder="mm-dd-yyyy" data-placeholder="MM-DD-YYYY" autocomplete="off"
aria-labelledby="label_151 sublabel_151_litemode" value=""><img class=" newDefaultTheme-dateIcon icon-liteMode" alt="Pick a Date" id="input_151_pick" src="https://cdn.jotfor.ms/images/calendar.png" data-component="datetime"
aria-hidden="false" data-allow-time="No" data-version="v1" aria-label="Choose Date" role="button" tabindex="0" aria-haspopup="dialog" aria-expanded="false"><label class="form-sub-label" for="lite_mode_151" id="sublabel_151_litemode"
style="min-height:13px">Date</label></span>
</div>
</div>
</li>
<li class="form-line jf-required" data-type="control_address" id="id_152" data-compound-hint=",,,,Please Select,,Please Select," data-css-selector="id_152"><label class="form-label form-label-top form-label-auto" id="label_152"
for="input_152_addr_line1" aria-hidden="false"> Residential address<span class="form-required">*</span> </label>
<div id="cid_152" class="form-input-wide jf-required">
<div summary="" class="form-address-table jsTest-addressField">
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-street-line jsTest-address-lineField"><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_152_addr_line1" name="q152_residentialAddress152[addr_line1]" class="form-textbox validate[required] form-address-line" data-defaultvalue="" autocomplete="section-input_152 address-line1" data-component="address_line_1"
aria-labelledby="label_152 sublabel_152_addr_line1" required="" value="" maxlength="100"><label class="form-sub-label" for="input_152_addr_line1" id="sublabel_152_addr_line1" style="min-height:13px">Street
Address</label></span></span></div>
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-street-line jsTest-address-lineField"><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_152_addr_line2" name="q152_residentialAddress152[addr_line2]" class="form-textbox form-address-line" data-defaultvalue="" autocomplete="section-input_152 address-line2" data-component="address_line_2"
aria-labelledby="label_152 sublabel_152_addr_line2" value="" maxlength="100"><label class="form-sub-label" for="input_152_addr_line2" id="sublabel_152_addr_line2" style="min-height:13px">Street Address Line 2</label></span></span>
</div>
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-city-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_152_city" name="q152_residentialAddress152[city]" class="form-textbox validate[required] form-address-city" data-defaultvalue="" autocomplete="section-input_152 address-level2" data-component="city"
aria-labelledby="label_152 sublabel_152_city" required="" value="" maxlength="60"><label class="form-sub-label" for="input_152_city" id="sublabel_152_city" style="min-height:13px">City</label></span></span><span
class="form-address-line form-address-state-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><input type="text" id="input_152_state" name="q152_residentialAddress152[state]"
class="form-textbox validate[required] form-address-state" data-defaultvalue="" autocomplete="section-input_152 address-level1" data-component="state" aria-labelledby="label_152 sublabel_152_state" required="" value=""
maxlength="60"><label class="form-sub-label" for="input_152_state" id="sublabel_152_state" style="min-height:13px">State / Province</label></span></span></div>
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-zip-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_152_postal" name="q152_residentialAddress152[postal]" class="form-textbox validate[required] form-address-postal" data-defaultvalue="" autocomplete="section-input_152 postal-code" data-component="zip"
aria-labelledby="label_152 sublabel_152_postal" required="" value="" maxlength="20"><label class="form-sub-label" for="input_152_postal" id="sublabel_152_postal" style="min-height:13px">Postal / Zip Code</label></span></span>
</div>
</div>
</div>
</li>
<li class="form-line jf-required" data-type="control_dropdown" id="id_153" data-css-selector="id_153"><label class="form-label form-label-top form-label-auto" id="label_153" for="input_153" aria-hidden="false"> Identifying document type<span
class="form-required">*</span> </label>
<div id="cid_153" class="form-input-wide jf-required"> <select class="form-dropdown validate[required]" id="input_153" name="q153_identifyingDocument153" style="width:150px" data-component="dropdown" required=""
aria-label="Identifying document type">
<option value="">Please Select</option>
<option value="State-issued driver's license">State-issued driver's license</option>
<option value="State/local/tribe-issued ID">State/local/tribe-issued ID</option>
<option value="U.S. passport">U.S. passport</option>
<option value="Foreign passport">Foreign passport</option>
</select> </div>
</li>
<li class="form-line jf-required" data-type="control_textbox" id="id_154" data-css-selector="id_154"><label class="form-label form-label-top form-label-auto" id="label_154" for="input_154" aria-hidden="false"> Identifying document number<span
class="form-required">*</span> </label>
<div id="cid_154" class="form-input-wide jf-required"> <input type="text" id="input_154" name="q154_identifyingDocument154" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="20"
data-component="textbox" aria-labelledby="label_154" required="" value=""> </div>
</li>
<li class="form-line jf-required" data-type="control_textbox" id="id_155" data-css-selector="id_155"><label class="form-label form-label-top form-label-auto" id="label_155" for="input_155" aria-hidden="false"> Identifying document
jurisdiction<span class="form-required">*</span> </label>
<div id="cid_155" class="form-input-wide jf-required"> <span class="form-sub-label-container" style="vertical-align:top"><input type="text" id="input_155" name="q155_identifyingDocument155" data-type="input-textbox"
class="form-textbox validate[required]" data-defaultvalue="" size="20" data-component="textbox" aria-labelledby="label_155 sublabel_input_155" required="" value=""><label class="form-sub-label" for="input_155" id="sublabel_input_155"
style="min-height:13px">U.S. State or Country/Jurisdiction</label></span> </div>
</li>
<li class="form-line jf-required" data-type="control_fileupload" id="id_156" data-css-selector="id_156"><label class="form-label form-label-top form-label-auto" id="label_156" for="input_156" aria-hidden="false"> Identifying document image<span
class="form-required">*</span> </label>
<div id="cid_156" class="form-input-wide jf-required">
<div data-wrapper-react="true">
<div data-wrapper-react="true" class="validate[multipleUpload] validate[required]">
<div class="qq-uploader">
<div class="qq-upload-drop-area" style="display: none;"><span>Drop files here to upload</span></div>
<div class="qq-upload-button " aria-hidden="true" style="position: relative; overflow: hidden; direction: ltr;">Browse Files</div>
<div class="inputContainer" role="button" aria-label="Browse Files" tabindex="0"><input multiple="multiple" class="fileupload-input" id="input_156" type="file" name="file" aria-labelledby="label_156" aria-hidden="true" tabindex="-1">
</div><label class="form-sub-label" aria-hidden="true" for="input_156" id="sublabel_156"></label><span style="display:none" class="multipleFileUploadLabels cancelText">Cancel</span><span style="display:none"
class="multipleFileUploadLabels ofText">of</span>
<ul class="qq-upload-list" aria-label="Uploaded files"></ul>
</div>
</div><span style="display:none" class="cancelText">Cancel</span><span style="display:none" class="ofText">of</span>
</div>
</div>
</li>
<li class="form-line" data-type="control_radio" id="id_157" data-css-selector="id_157"><label class="form-label form-label-top form-label-auto" id="label_157" for="input_157_0" aria-hidden="false"> Are you a Parent/Guardian applying for a
minor? </label>
<div id="cid_157" class="form-input-wide">
<div class="form-single-column" role="group" aria-labelledby="label_157" data-component="radio"><span class="form-radio-item" style="clear:left"><span class="dragger-item"></span><input aria-describedby="label_157" type="radio"
class="form-radio" id="input_157_0" name="q157_areYou157" value="Check if yes"><label id="label_input_157_0" for="input_157_0">Check if yes</label></span></div>
</div>
</li>
<li id="cid_185" class="form-input-wide" data-type="control_pagebreak" data-css-selector="id_185">
<div class="form-pagebreak" data-component="pagebreak">
<div class="form-pagebreak-back-container"><button id="form-pagebreak-back_185" type="button" class="form-pagebreak-back jf-form-buttons" data-component="pagebreak-back">Back</button></div>
<div class="form-pagebreak-next-container"><button id="form-pagebreak-next_185" type="button" class="form-pagebreak-next jf-form-buttons" data-component="pagebreak-next">Next</button></div>
<div class="form-pagebreak-next-container form-pagebreak-save-container"><button id="input_scl_185" type="button" class="form-submit-button form-sacl-button js-new-sacl-button jf-form-buttons sacl-button" data-component="button"
disabled="">Save</button></div>
<div style="clear:both" class="pageInfo form-sub-label" id="pageInfo_185"></div>
</div>
</li>
</ul>
<ul class="form-section page-section" style="display:none;">
<li id="cid_160" class="form-input-wide" data-type="control_head" data-css-selector="id_160">
<div class="form-header-group header-default">
<div class="header-text httal htvam">
<h2 id="header_160" class="form-header" data-component="header">Beneficial Owner(s) Information</h2>
</div>
</div>
</li>
<li class="form-line jf-required" data-type="control_textbox" id="id_161" data-css-selector="id_161"><label class="form-label form-label-top form-label-auto" id="label_161" for="input_161" aria-hidden="false"> Entity Name, or Individual's last
name<span class="form-required">*</span> </label>
<div id="cid_161" class="form-input-wide jf-required"> <input type="text" id="input_161" name="q161_entityName161" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="20" data-component="textbox"
aria-labelledby="label_161" required="" value=""> </div>
</li>
<li class="form-line" data-type="control_textbox" id="id_162" data-css-selector="id_162"><label class="form-label form-label-top form-label-auto" id="label_162" for="input_162" aria-hidden="false"> First name </label>
<div id="cid_162" class="form-input-wide"> <input type="text" id="input_162" name="q162_firstName162" data-type="input-textbox" class="form-textbox" data-defaultvalue="" size="20" data-component="textbox" aria-labelledby="label_162" value="">
</div>
</li>
<li class="form-line" data-type="control_textbox" id="id_163" data-css-selector="id_163"><label class="form-label form-label-top form-label-auto" id="label_163" for="input_163" aria-hidden="false"> Middle Name </label>
<div id="cid_163" class="form-input-wide"> <input type="text" id="input_163" name="q163_middleName163" data-type="input-textbox" class="form-textbox" data-defaultvalue="" size="20" data-component="textbox" aria-labelledby="label_163"
value=""> </div>
</li>
<li class="form-line jf-required" data-type="control_datetime" id="id_164" data-css-selector="id_164"><label class="form-label form-label-top form-label-auto" id="label_164" for="lite_mode_164" aria-hidden="false"> Date of Birth or Entity
Registration<span class="form-required">*</span> </label>
<div id="cid_164" class="form-input-wide jf-required">
<div data-wrapper-react="true">
<div style="display:none"><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[required, limitDate]" id="month_164" name="q164_dateOf164[month]" type="tel" size="2" data-maxlength="2"
data-age="" maxlength="2" required="" autocomplete="off" aria-labelledby="label_164 sublabel_164_month" value=""><span class="date-separate" aria-hidden="true"> -</span><label class="form-sub-label" for="month_164"
id="sublabel_164_month" style="min-height:13px">Month</label></span><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[required, limitDate]" id="day_164" name="q164_dateOf164[day]"
type="tel" size="2" data-maxlength="2" data-age="" maxlength="2" required="" autocomplete="off" aria-labelledby="label_164 sublabel_164_day" value=""><span class="date-separate" aria-hidden="true"> -</span><label
class="form-sub-label" for="day_164" id="sublabel_164_day" style="min-height:13px">Day</label></span><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[required, limitDate]"
id="year_164" name="q164_dateOf164[year]" type="tel" size="4" data-maxlength="4" data-age="" maxlength="4" required="" autocomplete="off" aria-labelledby="label_164 sublabel_164_year" value=""><label class="form-sub-label"
for="year_164" id="sublabel_164_year" style="min-height:13px">Year</label></span></div><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[required, limitDate, validateLiteDate]"
id="lite_mode_164" type="text" size="12" data-maxlength="12" maxlength="12" data-age="" required="" data-format="mmddyyyy" data-seperator="-" placeholder="mm-dd-yyyy" data-placeholder="MM-DD-YYYY" autocomplete="off"
aria-labelledby="label_164 sublabel_164_litemode" value=""><img class=" newDefaultTheme-dateIcon icon-liteMode" alt="Pick a Date" id="input_164_pick" src="https://cdn.jotfor.ms/images/calendar.png" data-component="datetime"
aria-hidden="false" data-allow-time="No" data-version="v1" aria-label="Choose Date" role="button" tabindex="0" aria-haspopup="dialog" aria-expanded="false"><label class="form-sub-label" for="lite_mode_164" id="sublabel_164_litemode"
style="min-height:13px">Date</label></span>
</div>
</div>
</li>
<li class="form-line jf-required" data-type="control_address" id="id_165" data-compound-hint=",,,,Please Select,,Please Select," data-css-selector="id_165"><label class="form-label form-label-top form-label-auto" id="label_165"
for="input_165_addr_line1" aria-hidden="false"> Residential address<span class="form-required">*</span> </label>
<div id="cid_165" class="form-input-wide jf-required">
<div summary="" class="form-address-table jsTest-addressField">
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-street-line jsTest-address-lineField"><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_165_addr_line1" name="q165_residentialAddress165[addr_line1]" class="form-textbox validate[required] form-address-line" data-defaultvalue="" autocomplete="section-input_165 address-line1" data-component="address_line_1"
aria-labelledby="label_165 sublabel_165_addr_line1" required="" value="" maxlength="100"><label class="form-sub-label" for="input_165_addr_line1" id="sublabel_165_addr_line1" style="min-height:13px">Street
Address</label></span></span></div>
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-street-line jsTest-address-lineField"><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_165_addr_line2" name="q165_residentialAddress165[addr_line2]" class="form-textbox form-address-line" data-defaultvalue="" autocomplete="section-input_165 address-line2" data-component="address_line_2"
aria-labelledby="label_165 sublabel_165_addr_line2" value="" maxlength="100"><label class="form-sub-label" for="input_165_addr_line2" id="sublabel_165_addr_line2" style="min-height:13px">Street Address Line 2</label></span></span>
</div>
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-city-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_165_city" name="q165_residentialAddress165[city]" class="form-textbox validate[required] form-address-city" data-defaultvalue="" autocomplete="section-input_165 address-level2" data-component="city"
aria-labelledby="label_165 sublabel_165_city" required="" value="" maxlength="60"><label class="form-sub-label" for="input_165_city" id="sublabel_165_city" style="min-height:13px">City</label></span></span><span
class="form-address-line form-address-state-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><input type="text" id="input_165_state" name="q165_residentialAddress165[state]"
class="form-textbox validate[required] form-address-state" data-defaultvalue="" autocomplete="section-input_165 address-level1" data-component="state" aria-labelledby="label_165 sublabel_165_state" required="" value=""
maxlength="60"><label class="form-sub-label" for="input_165_state" id="sublabel_165_state" style="min-height:13px">State / Province</label></span></span></div>
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-zip-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_165_postal" name="q165_residentialAddress165[postal]" class="form-textbox validate[required] form-address-postal" data-defaultvalue="" autocomplete="section-input_165 postal-code" data-component="zip"
aria-labelledby="label_165 sublabel_165_postal" required="" value="" maxlength="20"><label class="form-sub-label" for="input_165_postal" id="sublabel_165_postal" style="min-height:13px">Postal / Zip Code</label></span></span>
</div>
</div>
</div>
</li>
<li class="form-line jf-required" data-type="control_dropdown" id="id_166" data-css-selector="id_166"><label class="form-label form-label-top form-label-auto" id="label_166" for="input_166" aria-hidden="false"> Identifying document type<span
class="form-required">*</span> </label>
<div id="cid_166" class="form-input-wide jf-required"> <select class="form-dropdown validate[required]" id="input_166" name="q166_identifyingDocument166" style="width:150px" data-component="dropdown" required=""
aria-label="Identifying document type">
<option value="">Please Select</option>
<option value="State-issued driver's license">State-issued driver's license</option>
<option value="State/local/tribe-issued ID">State/local/tribe-issued ID</option>
<option value="U.S. passport">U.S. passport</option>
<option value="Foreign passport">Foreign passport</option>
</select> </div>
</li>
<li class="form-line jf-required" data-type="control_textbox" id="id_167" data-css-selector="id_167"><label class="form-label form-label-top form-label-auto" id="label_167" for="input_167" aria-hidden="false"> Identifying document number<span
class="form-required">*</span> </label>
<div id="cid_167" class="form-input-wide jf-required"> <input type="text" id="input_167" name="q167_identifyingDocument167" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="20"
data-component="textbox" aria-labelledby="label_167" required="" value=""> </div>
</li>
<li class="form-line jf-required" data-type="control_textbox" id="id_168" data-css-selector="id_168"><label class="form-label form-label-top form-label-auto" id="label_168" for="input_168" aria-hidden="false"> Identifying document
jurisdiction<span class="form-required">*</span> </label>
<div id="cid_168" class="form-input-wide jf-required"> <span class="form-sub-label-container" style="vertical-align:top"><input type="text" id="input_168" name="q168_identifyingDocument168" data-type="input-textbox"
class="form-textbox validate[required]" data-defaultvalue="" size="20" data-component="textbox" aria-labelledby="label_168 sublabel_input_168" required="" value=""><label class="form-sub-label" for="input_168" id="sublabel_input_168"
style="min-height:13px">U.S. State or Country/Jurisdiction</label></span> </div>
</li>
<li class="form-line jf-required" data-type="control_fileupload" id="id_169" data-css-selector="id_169"><label class="form-label form-label-top form-label-auto" id="label_169" for="input_169" aria-hidden="false"> Identifying document image<span
class="form-required">*</span> </label>
<div id="cid_169" class="form-input-wide jf-required">
<div data-wrapper-react="true">
<div data-wrapper-react="true" class="validate[multipleUpload] validate[required]">
<div class="qq-uploader">
<div class="qq-upload-drop-area" style="display: none;"><span>Drop files here to upload</span></div>
<div class="qq-upload-button " aria-hidden="true" style="position: relative; overflow: hidden; direction: ltr;">Browse Files</div>
<div class="inputContainer" role="button" aria-label="Browse Files" tabindex="0"><input multiple="multiple" class="fileupload-input" id="input_169" type="file" name="file" aria-labelledby="label_169" aria-hidden="true" tabindex="-1">
</div><label class="form-sub-label" aria-hidden="true" for="input_169" id="sublabel_169"></label><span style="display:none" class="multipleFileUploadLabels cancelText">Cancel</span><span style="display:none"
class="multipleFileUploadLabels ofText">of</span>
<ul class="qq-upload-list" aria-label="Uploaded files"></ul>
</div>
</div><span style="display:none" class="cancelText">Cancel</span><span style="display:none" class="ofText">of</span>
</div>
</div>
</li>
<li class="form-line" data-type="control_radio" id="id_170" data-css-selector="id_170"><label class="form-label form-label-top form-label-auto" id="label_170" for="input_170_0" aria-hidden="false"> Are you a Parent/Guardian applying for a
minor? </label>
<div id="cid_170" class="form-input-wide">
<div class="form-single-column" role="group" aria-labelledby="label_170" data-component="radio"><span class="form-radio-item" style="clear:left"><span class="dragger-item"></span><input aria-describedby="label_170" type="radio"
class="form-radio" id="input_170_0" name="q170_areYou170" value="Check if yes"><label id="label_input_170_0" for="input_170_0">Check if yes</label></span></div>
</div>
</li>
<li id="cid_186" class="form-input-wide" data-type="control_pagebreak" data-css-selector="id_186">
<div class="form-pagebreak" data-component="pagebreak">
<div class="form-pagebreak-back-container"><button id="form-pagebreak-back_186" type="button" class="form-pagebreak-back jf-form-buttons" data-component="pagebreak-back">Back</button></div>
<div class="form-pagebreak-next-container"><button id="form-pagebreak-next_186" type="button" class="form-pagebreak-next jf-form-buttons" data-component="pagebreak-next">Next</button></div>
<div class="form-pagebreak-next-container form-pagebreak-save-container"><button id="input_scl_186" type="button" class="form-submit-button form-sacl-button js-new-sacl-button jf-form-buttons sacl-button" data-component="button"
disabled="">Save</button></div>
<div style="clear:both" class="pageInfo form-sub-label" id="pageInfo_186"></div>
</div>
</li>
</ul>
<ul class="form-section page-section" style="display:none;">
<li id="cid_172" class="form-input-wide" data-type="control_head" data-css-selector="id_172">
<div class="form-header-group header-default">
<div class="header-text httal htvam">
<h2 id="header_172" class="form-header" data-component="header">Beneficial Owner(s) Information</h2>
</div>
</div>
</li>
<li class="form-line jf-required" data-type="control_textbox" id="id_173" data-css-selector="id_173"><label class="form-label form-label-top form-label-auto" id="label_173" for="input_173" aria-hidden="false"> Entity Name, or Individual's last
name<span class="form-required">*</span> </label>
<div id="cid_173" class="form-input-wide jf-required"> <input type="text" id="input_173" name="q173_entityName173" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="20" data-component="textbox"
aria-labelledby="label_173" required="" value=""> </div>
</li>
<li class="form-line" data-type="control_textbox" id="id_174" data-css-selector="id_174"><label class="form-label form-label-top form-label-auto" id="label_174" for="input_174" aria-hidden="false"> First name </label>
<div id="cid_174" class="form-input-wide"> <input type="text" id="input_174" name="q174_firstName174" data-type="input-textbox" class="form-textbox" data-defaultvalue="" size="20" data-component="textbox" aria-labelledby="label_174" value="">
</div>
</li>
<li class="form-line" data-type="control_textbox" id="id_175" data-css-selector="id_175"><label class="form-label form-label-top form-label-auto" id="label_175" for="input_175" aria-hidden="false"> Middle Name </label>
<div id="cid_175" class="form-input-wide"> <input type="text" id="input_175" name="q175_middleName175" data-type="input-textbox" class="form-textbox" data-defaultvalue="" size="20" data-component="textbox" aria-labelledby="label_175"
value=""> </div>
</li>
<li class="form-line jf-required" data-type="control_datetime" id="id_176" data-css-selector="id_176"><label class="form-label form-label-top form-label-auto" id="label_176" for="lite_mode_176" aria-hidden="false"> Date of Birth or Entity
Registration<span class="form-required">*</span> </label>
<div id="cid_176" class="form-input-wide jf-required">
<div data-wrapper-react="true">
<div style="display:none"><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[required, limitDate]" id="month_176" name="q176_dateOf176[month]" type="tel" size="2" data-maxlength="2"
data-age="" maxlength="2" required="" autocomplete="off" aria-labelledby="label_176 sublabel_176_month" value=""><span class="date-separate" aria-hidden="true"> -</span><label class="form-sub-label" for="month_176"
id="sublabel_176_month" style="min-height:13px">Month</label></span><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[required, limitDate]" id="day_176" name="q176_dateOf176[day]"
type="tel" size="2" data-maxlength="2" data-age="" maxlength="2" required="" autocomplete="off" aria-labelledby="label_176 sublabel_176_day" value=""><span class="date-separate" aria-hidden="true"> -</span><label
class="form-sub-label" for="day_176" id="sublabel_176_day" style="min-height:13px">Day</label></span><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[required, limitDate]"
id="year_176" name="q176_dateOf176[year]" type="tel" size="4" data-maxlength="4" data-age="" maxlength="4" required="" autocomplete="off" aria-labelledby="label_176 sublabel_176_year" value=""><label class="form-sub-label"
for="year_176" id="sublabel_176_year" style="min-height:13px">Year</label></span></div><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[required, limitDate, validateLiteDate]"
id="lite_mode_176" type="text" size="12" data-maxlength="12" maxlength="12" data-age="" required="" data-format="mmddyyyy" data-seperator="-" placeholder="mm-dd-yyyy" data-placeholder="MM-DD-YYYY" autocomplete="off"
aria-labelledby="label_176 sublabel_176_litemode" value=""><img class=" newDefaultTheme-dateIcon icon-liteMode" alt="Pick a Date" id="input_176_pick" src="https://cdn.jotfor.ms/images/calendar.png" data-component="datetime"
aria-hidden="false" data-allow-time="No" data-version="v1" aria-label="Choose Date" role="button" tabindex="0" aria-haspopup="dialog" aria-expanded="false"><label class="form-sub-label" for="lite_mode_176" id="sublabel_176_litemode"
style="min-height:13px">Date</label></span>
</div>
</div>
</li>
<li class="form-line jf-required" data-type="control_address" id="id_177" data-compound-hint=",,,,Please Select,,Please Select," data-css-selector="id_177"><label class="form-label form-label-top form-label-auto" id="label_177"
for="input_177_addr_line1" aria-hidden="false"> Residential address<span class="form-required">*</span> </label>
<div id="cid_177" class="form-input-wide jf-required">
<div summary="" class="form-address-table jsTest-addressField">
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-street-line jsTest-address-lineField"><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_177_addr_line1" name="q177_residentialAddress177[addr_line1]" class="form-textbox validate[required] form-address-line" data-defaultvalue="" autocomplete="section-input_177 address-line1" data-component="address_line_1"
aria-labelledby="label_177 sublabel_177_addr_line1" required="" value="" maxlength="100"><label class="form-sub-label" for="input_177_addr_line1" id="sublabel_177_addr_line1" style="min-height:13px">Street
Address</label></span></span></div>
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-street-line jsTest-address-lineField"><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_177_addr_line2" name="q177_residentialAddress177[addr_line2]" class="form-textbox form-address-line" data-defaultvalue="" autocomplete="section-input_177 address-line2" data-component="address_line_2"
aria-labelledby="label_177 sublabel_177_addr_line2" value="" maxlength="100"><label class="form-sub-label" for="input_177_addr_line2" id="sublabel_177_addr_line2" style="min-height:13px">Street Address Line 2</label></span></span>
</div>
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-city-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_177_city" name="q177_residentialAddress177[city]" class="form-textbox validate[required] form-address-city" data-defaultvalue="" autocomplete="section-input_177 address-level2" data-component="city"
aria-labelledby="label_177 sublabel_177_city" required="" value="" maxlength="60"><label class="form-sub-label" for="input_177_city" id="sublabel_177_city" style="min-height:13px">City</label></span></span><span
class="form-address-line form-address-state-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><input type="text" id="input_177_state" name="q177_residentialAddress177[state]"
class="form-textbox validate[required] form-address-state" data-defaultvalue="" autocomplete="section-input_177 address-level1" data-component="state" aria-labelledby="label_177 sublabel_177_state" required="" value=""
maxlength="60"><label class="form-sub-label" for="input_177_state" id="sublabel_177_state" style="min-height:13px">State / Province</label></span></span></div>
<div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-zip-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><input type="text"
id="input_177_postal" name="q177_residentialAddress177[postal]" class="form-textbox validate[required] form-address-postal" data-defaultvalue="" autocomplete="section-input_177 postal-code" data-component="zip"
aria-labelledby="label_177 sublabel_177_postal" required="" value="" maxlength="20"><label class="form-sub-label" for="input_177_postal" id="sublabel_177_postal" style="min-height:13px">Postal / Zip Code</label></span></span>
</div>
</div>
</div>
</li>
<li class="form-line jf-required" data-type="control_dropdown" id="id_178" data-css-selector="id_178"><label class="form-label form-label-top form-label-auto" id="label_178" for="input_178" aria-hidden="false"> Identifying document type<span
class="form-required">*</span> </label>
<div id="cid_178" class="form-input-wide jf-required"> <select class="form-dropdown validate[required]" id="input_178" name="q178_identifyingDocument178" style="width:150px" data-component="dropdown" required=""
aria-label="Identifying document type">
<option value="">Please Select</option>
<option value="State-issued driver's license">State-issued driver's license</option>
<option value="State/local/tribe-issued ID">State/local/tribe-issued ID</option>
<option value="U.S. passport">U.S. passport</option>
<option value="Foreign passport">Foreign passport</option>
</select> </div>
</li>
<li class="form-line jf-required" data-type="control_textbox" id="id_179" data-css-selector="id_179"><label class="form-label form-label-top form-label-auto" id="label_179" for="input_179" aria-hidden="false"> Identifying document number<span
class="form-required">*</span> </label>
<div id="cid_179" class="form-input-wide jf-required"> <input type="text" id="input_179" name="q179_identifyingDocument179" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="20"
data-component="textbox" aria-labelledby="label_179" required="" value=""> </div>
</li>
<li class="form-line jf-required" data-type="control_textbox" id="id_180" data-css-selector="id_180"><label class="form-label form-label-top form-label-auto" id="label_180" for="input_180" aria-hidden="false"> Identifying document
jurisdiction<span class="form-required">*</span> </label>
<div id="cid_180" class="form-input-wide jf-required"> <span class="form-sub-label-container" style="vertical-align:top"><input type="text" id="input_180" name="q180_identifyingDocument180" data-type="input-textbox"
class="form-textbox validate[required]" data-defaultvalue="" size="20" data-component="textbox" aria-labelledby="label_180 sublabel_input_180" required="" value=""><label class="form-sub-label" for="input_180" id="sublabel_input_180"
style="min-height:13px">U.S. State or Country/Jurisdiction</label></span> </div>
</li>
<li class="form-line jf-required" data-type="control_fileupload" id="id_181" data-css-selector="id_181"><label class="form-label form-label-top form-label-auto" id="label_181" for="input_181" aria-hidden="false"> Identifying document image<span
class="form-required">*</span> </label>
<div id="cid_181" class="form-input-wide jf-required">
<div data-wrapper-react="true">
<div data-wrapper-react="true" class="validate[multipleUpload] validate[required]">
<div class="qq-uploader">
<div class="qq-upload-drop-area" style="display: none;"><span>Drop files here to upload</span></div>
<div class="qq-upload-button " aria-hidden="true" style="position: relative; overflow: hidden; direction: ltr;">Browse Files</div>
<div class="inputContainer" role="button" aria-label="Browse Files" tabindex="0"><input multiple="multiple" class="fileupload-input" id="input_181" type="file" name="file" aria-labelledby="label_181" aria-hidden="true" tabindex="-1">
</div><label class="form-sub-label" aria-hidden="true" for="input_181" id="sublabel_181"></label><span style="display:none" class="multipleFileUploadLabels cancelText">Cancel</span><span style="display:none"
class="multipleFileUploadLabels ofText">of</span>
<ul class="qq-upload-list" aria-label="Uploaded files"></ul>
</div>
</div><span style="display:none" class="cancelText">Cancel</span><span style="display:none" class="ofText">of</span>
</div>
</div>
</li>
<li class="form-line" data-type="control_radio" id="id_182" data-css-selector="id_182"><label class="form-label form-label-top form-label-auto" id="label_182" for="input_182_0" aria-hidden="false"> Are you a Parent/Guardian applying for a
minor? </label>
<div id="cid_182" class="form-input-wide">
<div class="form-single-column" role="group" aria-labelledby="label_182" data-component="radio"><span class="form-radio-item" style="clear:left"><span class="dragger-item"></span><input aria-describedby="label_182" type="radio"
class="form-radio" id="input_182_0" name="q182_areYou182" value="Check if yes"><label id="label_input_182_0" for="input_182_0">Check if yes</label></span></div>
</div>
</li>
<li class="form-line" data-type="control_button" id="id_183" data-css-selector="id_183">
<div id="cid_183" class="form-input-wide">
<div data-align="auto" class="form-buttons-wrapper form-buttons-auto jsTest-button-wrapperField"><button id="input_scl_183" type="button" class="form-submit-button form-sacl-button js-new-sacl-button jf-form-buttons sacl-button"
data-component="button" disabled="">Save</button><button id="input_183" style="display:none !important" type="button" class="form-submit-button submit-button jf-form-buttons jsTest-submitField " data-component="button" data-content=""
aria-live="polite" disabled="">Submit</button><button type="button" class="form-submit-button submit-button jf-form-buttons jsTest-submitField useJotformSign-button useJotformSign " data-component="button" data-content=""
aria-live="polite" disabled="">Submit</button></div>
</div>
</li>
<li style="display:none">Should be Empty: <input type="text" name="website" value=""></li>
<li class="form-input-wide">
<div class="form-pagebreak">
<div class="form-pagebreak-back-container"><button id="form-pagebreak-back_69" type="button" class="form-pagebreak-back jf-form-buttons" data-component="pagebreak-back">Back</button></div>
</div>
</li>
</ul>
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* BETTER BOI
File your BOI form, or Face the Music
* THIS IS REQUIRED BY JANUARY 1, 2025
Spill the beans or face the music
* BENEFICIAL OWNERSHIP INFORMATION REPORTING
SPILL THE BEANS OR FACE THE MUSIC
THE NEW REALITY OF BUSINESS TRANSPARENCY
After years of uncertainty and shifting deadlines, the Corporate Transparency
Act's Beneficial Ownership Information (BOI) reporting requirement is now set
in stone. For millions of small businesses, this isn't just another
regulation – it's a mandatory disclosure with serious teeth.
WHAT'S REALLY GOING ON HERE?
The federal government wants to know who actually owns and controls American
businesses. No more hiding behind corporate veils. It's part of a global push
for transparency, and this time, they mean business.
THE HARD FACTS
* Final Deadline: January 1, 2025 for existing companies
* New Business: Must file within 30 days of formation
* Changes: Must update within 30 days of ownership changes
* Scope: Most companies with fewer than 20 employees must file
LET'S TALK ABOUT THOSE PENALTIES
Because sometimes a spoonful of sugar doesn't help the medicine go down:
- $500 per day in civil penalties
- Criminal fines up to $10,000
- Potential imprisonment up to 2 years
- Permanent compliance record issues
WHO NEEDS TO REPORT?
You're probably on the hook if you're a:
* Corporation
* LLC
* Limited Partnership
* Other similar entity
UNLESS YOU'RE:
* A public company
* Already heavily regulated (banks, credit unions)
* A tax-exempt organization
* Dormant (pre-2020, no activity, no foreign ownership)
WHY NOW?
The U.S. has been criticized for being a haven for shell companies and
financial opacity. This regulation brings us in line with international
standards. After multiple false starts and delays, the government is fully
committed to this deadline.
WE MAKE IT SIMPLE
Let's face it – nobody started their business dreaming about filing BOI
reports. That's why we're here.
1. Quick Assessment: 30-second check to determine if you need to file
2. Streamlined Collection: Simple forms, clear questions
3. Secure Filing: We handle the FinCEN submission
4. Peace of Mind: Updates and reminders when needed
WHY ACT NOW?
Think of January 1, 2025 like tax day – you don't want to be scrambling with
millions of other business owners at the last minute. Get it done now, and
get back to running your business.
Click on the blue button below to start your BOI Reporting
No payment required to check if you need to file
THE BOTTOM LINE
This isn't just another piece of paperwork you can ignore. The penalties are
serious, the deadline is firm, and the government is committed to
enforcement. But with our help, you can knock this out quickly and correctly.
STILL NOT SURE?
"But what if the requirements change again?"
They might adjust some details, but the core requirement isn't going away.
Filing early means you're covered, and we'll help you update if needed.
"What about privacy concerns?"
We take your privacy seriously, and FinCEN has strict data protection
protocols. This isn't public information – it's confidential government
reporting.
"Can't I just do this myself?"
We help you complete your BOI Reporting requirements for a flat fee, starting
at $250 for a simple report and going to $1,000+ for complex situations. We
offer hands on support and a white glove option, so you can get back to work!
"Can't I just do this myself?"
Yes! We would love for you to do this yourself. See the guide we have built
for self-filers. If you have any questions along the way you can schedule
time with us.
Click the blue button below to get started, and see if you need to file!
---
*Note: While we keep things light, we take compliance seriously. Our process
is designed for accuracy and completeness, backed by thorough understanding
of FinCEN requirements.*
* Do I need to file?
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* EXEMPTION CRITERIA
You might just get a free pass
* DO YOU NEED TO FILE?
There are a number of exemption criteria where your company might consolidate
the number of BOI forms it must file, or avoid filing BOI altogether.
Exemption requirements might include:
* Securities Reporting Issuer: Publicly traded companies that meet certain
requirements.
* Governmental Authority: Entities established by a government.
* Bank: Banks that are regulated and meet certain criteria.
* Credit Union: Federally insured credit unions.
* Depository Institution Holding Company.
* Money Services Business.
* Broker or Dealer in Securities.
* Securities Exchange or Clearing Agency.
* Other Exchange Act Registered Entity.
* Investment Company or Investment Adviser.
* Venture Capital Fund Adviser.
* Insurance Company.
* State-Licensed Insurance Producer.
* Commodity Exchange Act Registered Entity.
* Accounting Firm.
* Public Utility.
* Financial Market Utility.
* Pooled Investment Vehicle.
* Tax-Exempt Entity: Nonprofits and similar entities.
* Entity Assisting a Tax-Exempt Entity.
* Large Operating Company: Companies that employ more than 20 people in the
U.S., have over $5 million in gross revenue on their last tax return, and
have a physical presence in the U.S.
* Subsidiary of Certain Exempt Entities.
* Inactive Entity: Since prior to 2020, no activity, no foreign ownership)
* Does your company meet ANY of these exemption criteria?*
Based on one or more of these factors, I am an exempt entity.None of these
apply - I need to fileI am not sure
* Back
Next
Save
* GOOD NEWS!
You might just get a free pass
* GOOD NEWS! YOU MAY BE EXEMPT FROM BOI REPORTING
Based on your response, your company likely qualifies for an exemption from
BOI reporting requirements.
⚠️ IMPORTANT NEXT STEPS:
1. Document Your Exemption Status
- Keep records showing why you qualify for exemption
- Save relevant documentation (like SEC filings, tax-exempt status, etc.)
2. Verify Your Status
- While our assessment indicates you're exempt, we recommend:
* Consulting with your legal counsel
* Reviewing the full [FinCEN exemption guidelines](https://www.fincen.gov)
* Documenting your exemption determination
3. Stay Informed
- Exemption status can change if:
* Your business structure changes
* You lose tax-exempt status
* Regulatory requirements are updated
* Sign up for our updates to stay informed of any changes
Sign Up for BOI Regulation Updates
NEED MORE HELP?
If you'd like a professional review of your exemption status or have
questions, we're here to help.
Schedule a Consultation
* Back
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* NEED HELP?
Consult with us to get down the road
* LET'S SORT OUT YOUR BOI FILING TOGETHER
SIMPLE. PERSONAL. DONE RIGHT.
Confused about BOI requirements? Don't worry. In one phone call, we'll:
- Determine if you need to file
- Collect the right information
- Handle the submission process
- Ensure you're fully compliant
No complicated forms. No legal jargon. Just clear guidance from a real person
who knows BOI inside and out.
How It Works
1. Schedule a 30-minute call below
2. We'll walk you through everything step by step
3. You'll have peace of mind knowing it's handled correctly
Why Talk With Us?
- ✓ No prep needed - we'll guide you through it
- ✓ Get answers to all your questions
- ✓ Save hours of research and confusion
- ✓ Avoid costly mistakes and penalties
$500 Consultation Fee**
*Includes simple BOI filing if needed*
"We make BOI compliance as painless as a 30-minute call."
*
* Back
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* LET'S GET TO WORK!
First, let's confirm your authorization to file.
* Name of Reporting Company*
The Legal Name of your company on your tax returns.
* How many beneficial owners are there in the company?*
Count individuals who EITHER:
- Own 25% or more of the company, OR
- Exercise substantial control (senior officers, key decisions)
Each person may only be counted once, even if they meet both criteria.
* Your First and Last Name*
First NameLast Name
* Email Address*
example@example.com
* Phone Number
-Area CodePhone Number
* Please confirm the following:*
I am authorized to file BOI reports for this companyI understand that
providing false information may result in penaltiesI agree to notify of any
changes within 30 days
*
* Authorized Applicant's Signature*
Powered by Jotform SignClear
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* CHOOSE YOUR SERVICE
* Note - you will not pay until you have completed the forms, but you will not
be able to submit the forms without payment*
prevnext( X )
Simple BOI - up to 2 Beneficial Owners$250.00
Completion of a BOI Report with up to 2 Beneficial Owners. Includes Audit
Protection.
Complex BOI - 3+ Beneficial Owners$500.00
Completion of a BOI Report with 3+ Beneficial Owners. Includes Audit
Protection.
Done For You BOI$1,000.00
Completion of a BOI Report with 1-3+ Beneficial Owners. Includes Audit
Protection. We will request documents and complete this form for you!
Includes one 30 minute call if necessary.
Enter coupon Apply
Total $0.00
* Back
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* COMPANY APPLICANT INFORMATION
* Name*
First NameLast Name
* Date of Birth*
-Month -DayYear
Date
* FinCEN ID (if applicable)
* Current Address*
Street Address
Street Address Line 2
City Please Select Alabama Alaska Arizona Arkansas California Colorado
Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho
Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts
Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire
New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma
Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas
Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State
Zip Code
* Address type*
Business AddressResidential Address
* Identifying document type*
Please Select State-issued driver's license State/local/tribe-issued ID U.S.
passport Foreign passport
* Identifying document number*
* Identifying document jurisdiction*
U.S. State or Country/Jurisdiction
* Identifying document image*
Drop files here to upload
Browse Files
Cancelof
Cancelof
* Back
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Save
* REPORTING COMPANY INFORMATION
* Reporting Company legal name*
* Alternate name (e.g. trade name, DBA)
* Tax Identification type*
Please Select EIN SSN/ITIN Foreign
* Tax identification number*
* Country/Jurisdiction (if Foreign Tax ID)
* Current US Address*
Street Address
Street Address Line 2
City Please Select Alabama Alaska Arizona Arkansas California Colorado
Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho
Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts
Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire
New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma
Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas
Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State
Zip Code
*
* Benowner jump Number
* Back
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* WOAH THERE!
Let's go ahead and catch up on a call
* LET'S TAKE THE TIME TO GET THIS RIGHT
We are working to build the simplest, most straight forward BOI Reporting
tool out there.
Your answer of >5 beneficial owners makes us think that we might be better
served to have a quick conversation before we file this form.
We want to get it right!
Your consult fee will go to the cost of preparing the form. We will make this
quick and easy for you!
*
* Back
Next
Save
* BENEFICIAL OWNER(S) INFORMATION
* Entity Name, or Individual's last name*
* First name
* Middle Name
* Date of Birth or Entity Registration*
-Month -DayYear
Date
* Residential address*
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
* Identifying document type*
Please Select State-issued driver's license State/local/tribe-issued ID U.S.
passport Foreign passport
* Identifying document number*
* Identifying document jurisdiction*
U.S. State or Country/Jurisdiction
* Identifying document image*
Drop files here to upload
Browse Files
Cancelof
Cancelof
* Are you a Parent/Guardian applying for a minor?
Check if yes
* Back
Next
Save
* BENEFICIAL OWNER(S) INFORMATION
* Entity Name, or Individual's last name*
* First name
* Middle Name
* Date of Birth or Entity Registration*
-Month -DayYear
Date
* Residential address*
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
* Identifying document type*
Please Select State-issued driver's license State/local/tribe-issued ID U.S.
passport Foreign passport
* Identifying document number*
* Identifying document jurisdiction*
U.S. State or Country/Jurisdiction
* Identifying document image*
Drop files here to upload
Browse Files
Cancelof
Cancelof
* Are you a Parent/Guardian applying for a minor?
Check if yes
* Back
Next
Save
* BENEFICIAL OWNER(S) INFORMATION
* Entity Name, or Individual's last name*
* First name
* Middle Name
* Date of Birth or Entity Registration*
-Month -DayYear
Date
* Residential address*
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
* Identifying document type*
Please Select State-issued driver's license State/local/tribe-issued ID U.S.
passport Foreign passport
* Identifying document number*
* Identifying document jurisdiction*
U.S. State or Country/Jurisdiction
* Identifying document image*
Drop files here to upload
Browse Files
Cancelof
Cancelof
* Are you a Parent/Guardian applying for a minor?
Check if yes
* Back
Next
Save
* BENEFICIAL OWNER(S) INFORMATION
* Entity Name, or Individual's last name*
* First name
* Middle Name
* Date of Birth or Entity Registration*
-Month -DayYear
Date
* Residential address*
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
* Identifying document type*
Please Select State-issued driver's license State/local/tribe-issued ID U.S.
passport Foreign passport
* Identifying document number*
* Identifying document jurisdiction*
U.S. State or Country/Jurisdiction
* Identifying document image*
Drop files here to upload
Browse Files
Cancelof
Cancelof
* Are you a Parent/Guardian applying for a minor?
Check if yes
* Back
Next
Save
* BENEFICIAL OWNER(S) INFORMATION
* Entity Name, or Individual's last name*
* First name
* Middle Name
* Date of Birth or Entity Registration*
-Month -DayYear
Date
* Residential address*
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
* Identifying document type*
Please Select State-issued driver's license State/local/tribe-issued ID U.S.
passport Foreign passport
* Identifying document number*
* Identifying document jurisdiction*
U.S. State or Country/Jurisdiction
* Identifying document image*
Drop files here to upload
Browse Files
Cancelof
Cancelof
* Are you a Parent/Guardian applying for a minor?
Check if yes
* SaveSubmitSubmit
* Should be Empty:
* Back
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