Annual Llc Franchise Tax Report - Arkansas Secretary Of State - 2011

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Mark Martin, Arkansas Secretary of State
ANNUAL LLC 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: ____________________________________
Address: ____________________________________________
Address Line 2: _______________________________________
City, State, Zip: _______________________________________
Phone # of tax contact: _________________________________
E-mail address: _______________________________________
Required Information
Federal Tax ID# ______________________________________
Date of Qualification ___________________________________
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.
Principal Office Information:
Registered Agent Information:
5.
Address: _______________
Name: _____________
_______________________________
__________________________________
City, State Zip: __________________________
Address 1:
_____________
______________________________________________
Address 2: _____________________________
_____________
6.
City, State, Zip: _____________________________
________
LIMITED LIABILITY COMPANY MANAGEMENT IS:
(Select One)
MEMBER(S)
MANAGER(S)
Please provide current names:
Manager / Member ___________________________________
Manager / Member ___________________________________
Manager / Member ___________________________________
Manager / Member ___________________________________
Manager / Member ___________________________________
Tax Preparer:
ALL LIMITED LIABILITY COMPANIES PAY $150.00
ALL LIMITED LIABILITY COMPANIES PAY $150.00
TOTAL DUE
$150.00
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 __________________, ____________
This form must be signed in ink by: Member / Manager or Tax Preparer (Listed in 6 Above).
(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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