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Hellmuth & Johnson PLLC

8050 West 78th Street, Minneapolis, MN 55439
LOCAL 952-941-4005
FREE 888-343-3918
FAX 952-941-2337
info@hjlawfirm.com

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CORPORATE ENTITY UPDATE FORM

Summary Sheet

Name
Address
Contact
Telephone #
Fax #
E-Mail
Service Agent
Agent Address
Incorporation Date
Fiscal Year End
Annual Meeting Date
Sub-S
1244 Election
Tax ID #
Authorized Shares
Buy-Sell Agreement

Officers & Directors

Officers
President
Vice President
Secretary
Treasurer
Directors (List)

Shareholders

Name No. of Shares

Information Necessary for Filing the Annual Renewal

Principal Executive Office Address:
CEO Name and Business Address:

[Continued on next page]

Corporate Questionnaire

Name of Corporation:
Period Covered: to

For each question you mark "yes," please provide additional information in the space provided below the question. Please attach additional sheets if more space is required.

Business Names and Business Locations:

1.
Yes No
Has the Corporation changed its name or conducted business during the last year under any other business name?
  List other names used:
2.
Yes No
Has the Corporation changed its name or conducted business during the last year under any other business name?
  List nature of business activities, the number of individuals working or providing services, the type of property and/or lease(s), and identify the state for each:
3.
Yes No
Has the Corporation opened any new locations or facilities?
  List date, location and purpose of the new location(s):

Employees and Benefits:

4.
Yes No
Has the Corporation established new base salaries to any officers, directors or shareholders during the last year?
5.
Yes No
Has the Corporation paid extraordinary bonuses to any officers, directors or shareholders during the last year?
  List date, amount, name and office/capacity for salaries or bonuses:
6.
Yes No
Has the Corporation entered into (or amended) any employment agreements or significant other contractual arrangements with employees or individuals providing services to the Corporation during the last year? This would include email to/from employee or contractor regarding amount or timing of compensation, potential incentive compensation, etc.
  Employee, position, date and important terms of employment agreement (if available, attach copy of agreement and/or email evidencing terms):
7.
Yes No
Has the Corporation adopted or amended an employment handbook/manual during the last year?
  List date of employee handbook or manual adoption/modification:
8. Has the Corporation created or amended any of the following plan(s) during the last year?
 
Yes No
Pension?
Yes No
401(k) or other Profit Sharing?
Yes No
Medical Reimbursement?
Yes No
Other employee benefit plan?
  List the date and type (for adoption) or amount (for contribution) of employee plan:

Banking/Borrowing Transactions:

9.
Yes No
Has the Corporation opened new bank or other depository account(s) during the last year?
  List the financial institution, type of account, and authorized signatories on new account:
10.
Yes No
Has the Corporation borrowed money or made any loans during the last year?
  List date, amount, lender, terms and security of loans or borrowed money:

Subsidiaries/Joint Ventures:

11.
Yes No
Has the Corporation made any equity investments in other businesses?
  Summarize the equity investments:
12.
Yes No
Has the Corporation entered into any partnerships or joint ventures during the last year?
13.
Yes No
Does the Corporation have any other agreement(s) to share profits from any other activity with another person or entity?
  List name, type, date and nature of business of entity that you entered into partnership or venture with:

Major Transactions:

14.
Yes No
Has the Corporation purchased or sold any real estate or significant asset during the last year?
  List the date, purchase or sale, property or asset description and price of real estate or asset:
15.
Yes No
Has the Corporation entered into or amended a real estate lease as a tenant or landlord during the last year?
  List the date, property address, rent and term of lease:
16.
Yes No
Has the Corporation entered into any other unusual business transactions or arrangements during the last year?
  List the date, description and main business/commercial terms:

Owner Matters:

17.
Yes No
Has the Corporation declared or paid any dividends to its owners during the past year?
  List date, amount and reason for dividend:
18.
Yes No
Have there been any changes in stock ownership during the last year?
  List details of changes in stock ownership:
19.
Yes No
Has the Corporation entered into or amended any shareholder agreements during the last year?
  Identify shareholder agreement terms or amended terms:

General:

20.
Yes No
Does the Corporation have independent accountants?
  List name, address, services and contact person of independent accountants:
21.
Yes No
Have any other significant events or transactions occurred in the past year that are material to your business but not otherwise described in the foregoing list?
  Describe the significant events or transactions:

IF YOU HAVE ANY QUESTIONS ON COMPLETING THE QUESTIONNAIRE, PLEASE FEEL FREE TO CONTACT:

Entity Update Service at 952-941-4005

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