Corporation Franchise Tax Report (Non-Stock Corporation) Form - Arkansas Secretary Of State
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1Charlie Daniels, Arkansas Secretary of State
Franchise Tax Report, 2004 Reporting Year
Annual Report as of December 31, 2003
CORPORATION FRANCHISE TAX REPORT
(Non-Stock Corporation)
Reports and Taxes due on or before June 1, 2004. Substantial additional amounts due for reports with United States
Postal Services postmark after deadline. Reports may be filed over the Internet @
Report must be completed and signed in INK.
For Official Use Only
If tax contact information has changed, please correct below:
1.
Phone # of tax contact: ________________________
Required Information
2.
Federal Tax ID# _______________________________________
State of Incorporation ________________________
Please provide current names:
Secretary __________________________________
President ____________________________________________
Treasurer __________________________________
Vice-President ________________________________________
Controller __________________________________
$ 100.00
Corporations Without Authorized Stock Pay $100.00
TOTAL DUE
I declare, under the penalties of perjury, that the foregoing statements are true to the best of my knowledge and belief.
Signed this ______day of _______, _______ . Signature ______________________________________
(Day)
(Month)
(Year)
An officer listed in 2 above must sign this form in ink.
Due on or before June 1, 2004 -Substantial penalties due after June 1, 2004
Remittance must accompany this report and must be written and signed in ink.
Checks Payable to Arkansas Secretary of State • Phone (501)-682-3409 or 1-888-233-0325
Business and Commercial Services Division • P.O. Box 8014 • Little Rock, Arkansas 72203-8014
You may file this electronically over the Internet @
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