F ictitious / Trade / Assumed / DBA Business Names Biz License  Reseller's License / Sales Tax Id   Federal Tax Id   State Tax Id Corp. / LLC

Enter the first name, middle initial, last name, and SSN of  (a) the principal officer if the business is a corporation, (b) general partner if a partnership, (c) the owner of an entity Uthat is ( disregarded entities owned by a cororation enter the corpration's name and Ein) or (d) a grantor, owner name.