Form Fbt-01 - Application Form For Certificate Of Registration Of Foreign Business Trust - Arkansas Secretary Of State


Arkansas Secretary of State
State Capitol • Little Rock, Arkansas 72201-1094
501-682-3409 •
Business & Commercial Services, 250 Victory Building, 1401 W. Capitol, Little Rock
Application for Certificate of Registration
of Foreign Business Trust
(Please type or print)
Pursuant to the provisions of Act 1366 of 1999 the undersigned, as the duly authorized and acting member or managing
agent of the Foreign Business Trust for which this statement is submitted, under oath, does hereby state:
1a. The name of the Foreign Business Trust is:
1b. Assumed business name, it any:
2. The state, territory or foreign country under whose laws the Foreign Business Trust was organized is:
3. Physical location of principal office:
4. The name(s) and address(es) of the trustee(s) of the Foreign Business Trust is (are):
(Name or Names)
(Street Address)
(ZIP Code)
(Name or Names)
(Street Address)
(ZIP Code)
5a. The name and physical address of the registered agent for service:
(Street Address)
(ZIP Code)
5b. Acknowledgment and acceptance of appointment MUST be signed. I hereby acknowledge and accept the appoinment
of registered agent for and on behalf of the above named Foreign Business Trust.
I understand that knowingly signing a false document with the intent to file with the Arkansas Secretary of State is a Class C misde-
meanor and is punishable by a fine up to $100.00 and/or imprisonment up to 30 days.
(Authorized Signature)
Authorizing Officer (Type or Print)
6. A filing fee of $300.00 is submitted herewith in accordance with Act 1366 of 1999.
IN WITNESS THEREOF, the undersigned has executed this application on this day of _______________________.
(Name of Foreign Business Trust)
State of
County of
Subscribed and sworn to before me, a Notary Public, this
, day of
Signature of Notary Public (Please apply seal at right)
Fee: $300.00 payable to Arkansas Secretary of State
FBT-01 Rev. 4/06


00 votes

Related Articles

Related forms

Related Categories

Parent category: Legal