Annual Bank Franchise Tax Report - Arkansas Secretary Of State - 2011
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1999999999
Mark Martin, Arkansas Secretary of State
ANNUAL BANK FRANCHISE TAX REPORT 2011
For the year ending 12/31/2010
Reports and Taxes are due on or before May 1, 2011. Penalty and Interest will be due for reports if the United States Postal Service’s
postmark is after the deadline. Complete this report online at or sign in ink and mail to the address
listed below.
1.
Save time, file online at anytime
day or night at
.
Correct any information, if needed, in space provided below
2.
Tax contact name: ____________________________________
State of ___________________________________________
Address: ____________________________________________
County of _________________________________________
Address Line 2: _______________________________________
Date of Qualification ________________________________
City, State, Zip: _______________________________________
Phone # of tax contact: _________________________________
E-mail address: _______________________________________
Required Information
Federal Tax ID# ______________________________________
3.
___A
4, 5 & 6
LL OF THE INFORMATION IN SECTION
HAS
BEEN VERIFIED AND HAS BEEN FOUND TO BE EXACTLY THE
.
SAME AS LAST YEARS REPORT
4.
TOTAL AUTHORIZED CAPITAL STOCK:
(See Instruction 9)
NUMBER OF SHARES
PAR VALUE EACH
*a
$
*b
$
*c
$
NO PAR VALUE =$25 PER SHARE
5.
ISSUED AND OUTSTANDING CAPITAL STOCK:
(See Instruction 10)
NUMBER OF
PAR VALUE EACH
$ TOTAL
SHARES
*a
X $
= $
*b
X $
= $
*c
= $
X $
No PV=$25 per share
*d
(Add 5a +5b + 5c) TOTAL:
= $
6.
ARKANSAS ASSETS
÷
TOTAL ASSETS
=
PERCENTAGE
X AMOUNT FROM LINE 5D = ARKANSAS CAPITOL STOCK
X .003
=
TAX DUE
MINIMUM TAX DUE $150 • IF LESS THAN $150 PAY $150 • Banks Without Authorized Stock Pay $300.00
I declare, under the penalties of perjury, that the foregoing statements are true to the best of my knowledge and belief.
Signature________________________________________ Executed this _________ day of __________________, ____________
Must be signed in ink by: Pres., Sec., Vice-Pres., Treasurer, or Tax Preparer
(Day)
(Month)
(Year)
Due on or before May 1, 2011 – Penalty and Interest due after May 1, 2011
You may file this electronically over the Internet @
Remittance must accompany this report • Make Checks Payable to Arkansas Secretary of State
Phone 501-682-3409 or 1-888-233-0325
Mail to: Business and Commercial Services Division • P.O. Box 8014 • Little Rock, Arkansas 72203-8014
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