Land Trust Entity Formation

General Information

Entity Name (e.g., Bluffton Land Trust, LLC)(Required)

Formation Date(Required)

City of Operations(Required)

Registered Agent Name(Required)

Registered Agent Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Member and Ownership Details

Sole Member Name (e.g., Wells County Community Foundation)(Required)

Member Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Initial Capital Contribution (Default: $100)(Required)

Board of Managers

Manager 1 Name(Required)

Manager 1 Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Manager 1 Preferred Email(Required)

Manager 1 Preferred Phone(Required)

Manager 2 Name(Required)

Manager 2 Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Manager 2 Preferred Email(Required)

Manager 2 Preferred Phone

Manager 3 Name(Required)

Manager 3 Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Manager 3 Preferred Email(Required)

Manager 3 Preferred Phone

Manager 4 Name(Required)

Manager 4 Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Manager 4 Preferred Email(Required)

Manager 4 Preferred Phone

Manager 5 Name(Required)

Manager 5 Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Manager 5 Preferred Email(Required)

Manager 5 Preferred Phone

Ex Officio Members

Ex Officio Member 1 (Appointed by Mayor)(Required)

Ex Officio Member 2 (Appointed by Mayor)

Employer Identification Number (EIN) Details

Responsible Party Name(Required)

Business Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Business Address is different than Mailing Address(Required)

Yes

No

Mailing Address

Street Address City State / Province / Region ZIP / Postal Code

Financial and Banking Setup

Initial Bank Deposit Amount (Default: $100)(Required)

Bank Name(Required)

Number of Accounts to Open(Required)

Compliance and Documentation

Beneficial Owner Name (Sole Member)(Required)

Required Documents Attached

Max. file size: 300 MB.

Signatures

Prepared By(Required)

Date(Required)

Land Trust Entity Formation

General Information

Member and Ownership Details

Board of Managers

Ex Officio Members

Employer Identification Number (EIN) Details

Financial and Banking Setup

Compliance and Documentation

Signatures

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