Fill out this form so we can submit the BE-13 report for your company. Confidentiality Clause * At Urson, we are committed to safeguarding the privacy and confidentiality of the personal data provided by our clients. This data will only be used for the specific purpose agreed upon, with your explicit consent. We implement appropriate security measures to protect the information, and only authorized personnel will have access. Your data will not be shared with third parties unless required by law or with your explicit consent. We adhere to data protection laws and cooperate with the relevant authorities when necessary. Do you accept and acknowledge Urson’s Confidentiality Clause? I accept Legal name of the company * Structure of the company * LLC CORP Company EIN * Company legal address * Address 1 Address 2 City State/Province Zip/Postal Code Country Company incorporation date * MM DD YYYY State of register * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minessota 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 Business activity * Primary Beneficial Owner’s Full Name * First Name Last Name Provide the names and countries of residence of all other owners. * Is the total cost of acquiring, expanding, or establishing the business greater than $3 million? Yes No Thank you!
