ONTROL http://www.com.ohio.gov/liqr OFFICER/ SHAREHOLDERS DISCLOSURE FORM (This form must accompany all applications of a corporate business entity) Name of Corporation DBA Name Permit Premises Address City, State Township, if in Unincorporated Area Tax Identification No. (TIN) Zip Code Email Address: SECTION B. 1. Is stock publicly traded? If "YES", YES NO YES NO indicate exchange ______________________________ & Do NOT complete SECTION D. 2. Does any stockholder own 5% or more .
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How to fill out the OH DLC4030 online
The OH DLC4030 form, also known as the Officer/Shareholders Disclosure Form, is essential for corporate business entities applying for permits in Ohio. This guide provides a step-by-step walkthrough for completing the form online effectively and accurately.
Follow the steps to successfully complete the OH DLC4030 form.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- In Section A, provide the name of your corporation, the doing-business-as (DBA) name, and the permit premises address. Fill in the city, state, township (if applicable), tax identification number (TIN), and zip code. Lastly, ensure to include your email address for correspondence.
- Proceed to Section B. Answer the question about whether the stock is publicly traded by selecting 'YES' or 'NO'. If 'YES', indicate the exchange and skip Section D. If any stockholder owns 5% or more shares, complete Section D. Also, enter the total number of shares issued.
- In Section C, list the top five officers of the corporation. For each officer, include their name, social security number, and date of birth. If an office is not held, clearly write 'NONE'. Remember that a background check is required for these individuals.
- Next, move to Section D. This section is for stockholders holding 5% or more outstanding shares. If you indicated that the stock is publicly traded, do not complete this section. For each stockholder, provide their name, social security number (if applicable), residence address, tax identification number (if applicable), city and state, telephone number, zip code, and date of birth. Indicate the number of shares held, not the percentage.
- If there are more stockholders than can fit in the provided space, continue your listing on the reverse side of the form as needed.
- Complete the affidavit section where the authorized representative of the corporation must provide their signature, title, and printed name and corporate title. Include the date and have the document notarized.
- After filling out the form, review all entries for accuracy. Once confirmed, proceed to save changes, download, print, or share the completed form as required.
Get started today and complete the OH DLC4030 form online for your business needs.
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