Are you a current NRAI client?     Yes  No 

EMAIL ADDRESS: Please enter the email address from which you are submitting this form. By entering this information, we will be better able to track your order.

Client information

1. COMPANY NAME AND ADDRESS: Enter the complete name of the entity to be represented by NRAI, which MUST be exactly as it appears on the records of the Secretary of State of the State of Incorporation, and the Address of the entity being represented. If you use a P.O. Box for the company address, please set forth a specific STREET address for handling Service of Process via Federal Express.

Company Name
Contact Individual
Address
 
City State Zip
Telephone
Fax

2. COUNSEL NAME AND ADDRESS: (OPTIONAL) Enter the complete name and address of the Counsel representing the entity. If you use a P.O. Box for the counsel address, please request a specific STREET address for handling Service of Process via Federal Express. It is important that a complete name and address is listed, no abbreviations please (i.e., "etal").  Tell me more about this question

Company Name
Contact Individual
Address
 
City State Zip
Telephone
Fax

3. PARENT COMPANY NAME: If the new representation is a part of a Group of companies or is the Parent company of a Group of companies, please enter the Parent Company's Name here.

4. STATE OF INCORPORATION: Enter jurisdiction where entity was incorporated. This is called the Domestic State and is a mandatory field as it will become our main company identifier at NRAI.

5. DATE OF INCORPORATION:  (mm/dd/yyyy) List the date of Incorporation or Organization in the home state of domestication.

6. FISCAL YEAR END: Enter company's fiscal year end date (month & day). This information is necessary for those companies subscribing to our Tax Notification Service.

7. FEDERAL IDENTIFICATION NUMBER: List the Federal ID# assigned by the Internal Revenue Service. In many jurisdictions, this number is used as the State Identification Number and will assist NRAI in properly identifying and forwarding communications received from State Agencies.

Communications

8. SERVICE OF PROCESS ADDRESS: Choose either Company or Counsel Address and enter individual attention and telephone number if applicable. All Service of Process and State Notices of Delinquency/Revocation will be mailed to this address. It is recommended that all communications in this category be sent directly to COUNSEL for the entity being represented.
      Same as Company  Same as Counsel   

9. TAX & ROUTINE COMMUNICATIONS: Choose either Company or Counsel Address and enter individual attention and telephone number if applicable. All Annual Report forms, Tax Reports & General Corres. will be mailed to this address. It is recommended that all communications in this category be sent directly to the ENTITY being represented.
      Same as Company  Same as Counsel   

10. RENEWAL INVOICING ADDRESS: Choose either Company or counsel Address and enter individual attention and telephone number if applicable. All NRAI Annual Representation Invoices will be mailed to this address. If more than one addressee is required for Service of Process, or if there are Special Routing Instructions like mandatory telephone calls or copies of transmittal letters to be sent elsewhere, please set forth Special Instructions on an attachment. Please be as specific as possible. It is recommended that all communications in this category be sent directly to the ENTITY being represented.
      Same as Company  Same as Counsel