BOIR Reporting Request

Please read all questions thoroughly.

Company name

Preparer Full Legal Name

Preparer of this Form Legal Relationship to the Business:

Please upload one of the following documents:

Please submit EIN letter

Latest Business Tax Return

EIN Documentation from IRS

Date the business opened

Please list your companies FinCEN ID if you have filed one of these reports in the past.

If you do not have one and this is your first report please type "N/A"

Please submit a copy of your state filing

Acceptable formats: PDF, JPG or PNG

Please check any of the following scenarios that apply to your business:

You are a Large Corporation that has 20+ Employees and $5 million in gross receipts

You are a Publicly Traded Company

You are a Bank

You are a Credit Union

You are inactive entity

You are Government Authority

You are an SEC documented Investment Company/Advisor

Who is/are the legal owners of your company?

Please use legal names as shown on ID provided.

All Legal Owners of your business must submit acceptable Identification for the Application.

Owners please upload 1 of the following items: DLs, Passport, State/Local/Tribe ID, or Foreign Passport

Who is/are the legal beneficiaries of your company?

If you don't have any, please explicit declare in the text box that you do not have any.

All Legal Beneficiaries of your business must submit acceptable Identification for the Application.

Benefactors please upload 1 of the following items: DLs, Passport, State/Local/Tribe ID, or Foreign Passport (For Will, Estate or Trusts please attach copies of the agreements)

Who is/are the investors of your company?

Please include legal name, city, state and country. If you don't have any, please explicit declare in the text box that you do not have any.

List ALL interested parties that exist for your business?

Please include legal name, city, state and country. If you don't have any, please explicit declare in the text box that you do not have any.

Do you have any offshore accounts?

No

Yes, add the banks:

This includes bank accounts outside of the United States

Do you have any offshore businesses?

Yes

No

This includes businesses outside of the United States.

Danelle Davis, CPA is not an interested party, owner, has controlling interest, or relation to the business noted in this request.

True

False

If you are friend or family member of Danelle, but she does not obtain a financial gain from being apart of your normal business operations, please select True.

Do you have dual citizenship both in the United States and in another country?

Yes

No

A beneficial owner or owner of the business has been previously investigated by the FBI, SEC or another US governing body for: Business Risk, Misappropriation, Embezzlement, Tax Fraud or Money Laundering.

True

False

I hereby certify that the information provided is accurate, complete, and lawful to the best of my knowledge and belief.

I hereby certify that my fee to Danelle Davis, CPA for preparing and presenting my application to the Financial Crimes Enforcement Network on behalf does not in anyway constitute an approval for my BOI application. I understand that Danelle Davis, CPA of Davis Deviation, is being hired to compile all my business information to submit an application on my behalf with no guarantee on the outcome.

I was referred by member, owner or affiliate of TurnKey Investors & Financial Services.

If you were not referred by Turnkey Investors, please leave the above box blank.

Requestor Legal Name and Acknowledgment to the above statements.

Requestor Signature

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BOIR Reporting Request

Please upload one of the following documents:

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