Dissolution/Entity Request Form

Equity Redemption Paperwork Request-Entity Dissolution

Once equity from a dissolution request has been transferred into the names of the entitled parties, it is handled just as any other personal equity balance would be handled (age payouts, estate payouts, etc.)
Age payouts are processed once per year. They are voted on after the fiscal year-end audit by the board of directors. There are no exceptions.
Estate payouts are processed once per quarter. They are voted on at the quarterly board of directors meeting. There are no exceptions.
For any additional questions, please contact EquityInfo@ALCIVIA.com or call 608.819.3102.

Entity Name

Entity account numbers

Please separate multiple account numbers with a comma

Has the entity dissolved?

Yes

Contact Name

First

Last

Contact would like paperwork via:

Physical Mail

Email Address

Contact Phone Number

Mailing Address

City

State/Province

Zip/Postal

Will someone continue to utilize the account?

Yes

Please list all the members of the entity, their ownership percentage, and the ALCIVIA account number for each member.

Please add any additional comments or notes about this request

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