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State of New Jersey Public Records Filing For New Business Entity

This form is to file public records for a new business entity with the New Jersey Division of Revenue. The form provided here is simply a sample of what the actual form looks like.

STATE OF NEW JERSEY
DIVISION OF REVENUE

Mail to: PO Box 308
Trenton, NJ 08625

Overnight to: 225 West State St.
3rd Floor
Trenton, NJ 08608-1001


PUBLIC RECORDS FILING FOR NEW BUSINESS ENTITY

Fill out all information below INCLUDING INFORMATION FOR ITEM 12, and sign in the space provided. Please note that once filed, this form constitutes your original certificate of incorporation/formation/registration/authority, and the information contained in the filed form is considered public. Refer to the instructions for delivery/return options, filing fees and field-by-field requirements. Remember to remit the appropriate fee amount. Use attachments if more space is required for any field, or if you wish to add articles for the public record.

1. Business Name: _________________________________

2. Alternate Business Name: _________________________________

3. Type of Business Entity: _________________________________
(See Instructions for Codes, Page 19, Item 3)

4. Business Purpose : _________________________________
(See Instructions, Page 20, Item 4)

5. Stock (Domestic Corporations Only - Total Shares): _________________________________

6. Duration (If Indefinite or Perpetual, Leave Blank): _________________________________

7. State of Formation/Incorporation (Foreign Entities Only): _________________________________

8. Date of Formation/Incorporation (Foreign Entities Only): _________________________________

9. Contact Information:

Registered Agent Name: ______________________________

Registered Office (Must be a New Jersey address with street address)

Street ________________________________

City _________________________________

Zip _______________

Main Business or Principal Business Address (If different than the Registered Office)

Street _________________________________

City _________________________________

State_________

Zip ___________

10. Management (Domestic Corporations and Limited Partnerships Only)

• For-Profit and Professional Corporations list initial Board of Directors, minimum of 1;
• Domestic Non-Profits list Board of Trustees, minimum of 3;
• Limited Partnerships list all General Partners.

Name _______________________________

Street Address ___________________________________

City ______________________

State ________

Zip ________________


Name _______________________________

Street Address ___________________________________

City ______________________

State ________

Zip ________________


The signatures below certify that the business entity has complied with all applicable filing requirements pursuant to the laws of the State of New Jersey.

11.Incorporators (Domestic Corporations Only, minimum of 1)

Name _______________________________

Street Address ___________________________________

City ______________________

State ________

Zip ________________

Name _______________________________

Street Address ___________________________________

City ______________________

State ________

Zip ________________

** Signature(s) for the Public Record (See instructions for Information on Signature Requirements)

Signature ________________________________________

Name ______________________________

Title ________________________

Date __________________


Signature ________________________________________

Name ______________________________

Title ________________________

Date __________________

12. Additional Entity - Specific Information

A. Domestic Non-Profit Corporations (Title 15A)

• The corporation shall have members: . . . . . . . . . . . ____ Yes ____ No

If yes, qualification shall be:

____ As set forth in the by-laws or,

____ As set forth herein: ______________________________

• The rights and limitations of the different classes of members shall be:

____ As set forth in the by-laws or,

____ As set forth herein: ______________________________

• The method of electing the trustees shall be:

____ As set forth in the by-laws or,

____ As set forth herein: ______________________________

• The method of distribution of assets shall be:

____ As set forth in the by-laws or,

____ As set forth herein: ______________________________

B. Foreign Corporations - Profit, Non-Profit and Foreign Legal Professional (Titles 14A and 15A)
Attach a certificate of good standing/existence from the state of formation/incorporation not greater than 30 days old to this form.

______________________________

C. Limited Partnerships (Title 42:2A)

• Set forth the aggregate amount of cash and a description and statement of the agreed value of other property or services contributed (or to be contributed in the future) by all partners: ______________________________

• Do the limited partners have the power to grant the right to become a limited partner to an assignee of any part of their partnership . . . . . . . . . . . . . . . . ____ Yes ____ No

If yes, list the terms/conditions of that power: ______________________________

• Do the limited partners have the right to receive distributions from a partner which includes a return of all or any part of the partner's contributions? . . . . . ____ Yes ____ No

If yes, list the applicable terms: ______________________________

• Do the general partners have the right to make distributions to a partner which includes a return of all or any part of the partner's contributions? . . . . . . . . . . . . . . . ____ Yes ____ No

If yes, list the applicable terms: ______________________________

• What are the rights of the remaining general partners to continue the business in the event that a general partner withdraws? List below:

______________________________

D. Foreign Limited Partnerships (Title 42:2A)

• Set forth the aggregate amount of cash and a description and statement of the agreed value of other property or services contributed (or to be contributed in the future) by all partners: ______________________________

• Attach a certificate of good standing/existence from the state of formation/incorporation not greater than 30 days old to this form.

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