COLORADO BUSINESS EXPRESS COLORADO DEPT OF REVENUE

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1 Instructions: Please print this document for your records. LORDO BUSINESS EXPRESS LORDO DEPT OF REVENUE Thank you for registering with the Colorado Department of Revenue! Your electronic application has been received. You will receive your Sales Tax License and/or Wage Withholding information in the mail in the next 10 business days. You may use this receipt as a temporary Sales Tax License in the interim. Filing Information Your filing information is as follows: Date: Name: ddress: 09/10/ :56 EvoGov, Inc., Sales Tax ccount Number: Sales Tax Filing Frequency: Wage Withholding ccount Number: Wage Withholding Filing Frequency: N/ N/ $7,000-$49,999/Year - Monthly Websites State of Colorado: Colorado Department of Revenue: Colorado Department of Revenue Online Customer Support Site: revenuestateco.custhelp.com File and pay your sales tax online: Register to pay by EFT: Please wait 2-3 business days while we validate your registration before attempting to access your account in Revenue Online. You will receive your license(s) in the mail within 10 business days. If you do not already have access to Revenue Online, you may use information from that letter to sign-up.

2 Secretary of State Registration Have you registered with the Secretary of State? Yes Is your business: Other Is your organization a religious organization? Is your business classified as: n agricultural employer, a household/domestic employer, 501(C)(3) employer, or other non-profit employer? Do you already have an unemployment account number for your business? Do you already have a Sales Tax number for your business?

3 Business Organization Information Business Name EvoGov, Inc. Type of Organization Corporation re any employees who perform services in Colorado paid wages? Yes Contact Name John McKown Do you have an FEIN? Yes FEIN Street ddress 1 State Zip Code County Douglas Telephone Is your business within the city limits? In Care Of John McKown Same as Street ddress false

4 Mailing ddress 1 State/Province Zip Code Country US Country Code 001 Telephone Contact Person John McKown Worksite ddress 1 State Zip Code County Douglas Telephone Contact Name for all Worksites John McKown How many worksite locations do you have? 1 verage Monthly Employees 2

5 Owners, Partners, Corporate Officers First Name 1 John Last Name 1 McKown Title 1 President SSN FEIN of Existing Business Street State/Province 1 Zip Code Country 1 US Country Code Telephone

6 Employee re any employees who perform services in Colorado paid wages? Yes Filing Frequency: if wage withholding amount is: $7,000-$49,999/Year - Monthly Enter the date you paid or will pay $ in a single quarter or check N/. (Future dates up to 90 days from current day permitted.) 11/1/2015 N/ false N/ true Based on the information you provided, this is your estimated ualifying Date: 11/01/2015 Enter the first date you paid wages during the calendar year of your estimated ualifying Date (displayed above). 09/01/2015

7 Bank Information Bank Name Wells Fargo Bank ccount Number Bank Routing Number Verify Bank ccount Number Verify Bank Routing Number Street ddress E rapahoe Rd Street ddress 2 Ste 100 Greenwood Village State/Province Zip Code Country US Country Code 001 Telephone

8 Payroll Information Contact First Name John Contact Last Name McKown Street ddress 1 State/Province Zip Code Country US Country Code 001 Telephone Products and Services Will you be providing: Services Type of Products and Services NIC

9 Products and Services - Detail Please list SPECIFIC products or service (s) and EXPLIN IN DETIL. If more than one activity, make ONE a PREDOMINNT percent, (e.g %). Web Page Design and/or Management Services (100) Is contractor or sub-contractor labor used? Seasonal Business Is this a seasonal business?