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Click ‘Get Form’ to open the statement ime in the editor.
Begin by entering the Entity Name(s) as registered with the Department of State. Ensure you attach copies of organizational documents like articles of incorporation.
Fill in the Federal Tax ID No(s.) and provide the name(s) under which your entity conducts business, along with any associated website URLs.
Complete the contact information for a designated representative, including their name, title, and phone number.
List all administrative office addresses and New York business locations where your IME entity operates.
Answer questions regarding criminal convictions of officers or partners, detailing any necessary explanations.
Describe services provided by your IME entity and include details about employees or independent contractors involved.
Utilize the blank page provided to summarize your scheduling approach for IMEs, ensuring clarity on all services offered during this process.
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