Annual Corporation Franchise Tax Report - Arkansas Secretary Of State - 2013
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1Mark Martin
, Arkansas Secretary of State
123456789
ANNUAL CORPORATION FRANCHISE TAX REPORT 2013
For the year ending 12/31/2012
Reports and taxes are due on or before May 1, 2013. 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 black ink and mail to the
address listed below.
1.
Save Time & File Online
Anytime Day Or Night At
Date of Qualification:
2.
Correct any information, if needed, in space provided below:
5.
State of Incorporation:
Tax Contact Name:
Nature of Business:
Address:
Address Line 2:
6.
TOTAL AUTHORIZED CAPITAL STOCK
City, State, Zip:
(See Instruction 13)
Phone # of Tax Contact:
NUMBER OF SHARES
PAR VALUE EACH
E-mail Address:
*a
$
Required Information:
*b
$
Federal Tax ID#:
*c
$
3.
NO PAR VALUE =$25 PER SHARE
___ A
4, 5, 6, 7 &
LL OF THE INFORMATION IN SECTIONS
8
HAS BEEN VERIFIED AND HAS BEEN FOUND TO BE
7.
ISSUED AND OUTSTANDING CAPITAL STOCK
.
’
EXACTLY THE SAME AS LAST YEAR
S REPORT
(See Instruction 14)
NUMBER OF
4a.
PAR VALUE EACH
TOTAL
Registered Agent Information:
SHARES
Name:
*a
X $
= $
Address 1:
*b
X $
= $
Address 2:
*c
X $
= $
No PV=$25 per share
City, State, Zip:
*d
(Add 7a +7b + 7c) TOTAL:
= $
Principal Office Information:
Address:
City, State Zip:
4b.
Current Names of Corporate Governors:
President: ______________________________________
Vice-President: __________________________________
Secretary: ______________________________________
Treasurer: ______________________________________
Controller: ______________________________________
Tax Preparer: ____________________________________
8.
ARKANSAS ASSETS
÷
TOTAL ASSETS
=
PERCENTAGE
X AMOUNT FROM LINE 7D = ARKANSAS CAPITAL STOCK
X .003
=
TAX DUE
MINIMUM TAX DUE $150 • I F LESS THAN $150 PAY $150 • CORPORATIONS WITHOUT AUTHORIZED STOCK PAY $300
I declare, under the penalties of perjury, that the foregoing statements are true to the best of my knowledge and belief.
Executed this _________ day of __________________, ____________
(Day)
(Month)
(Year)
Print Name________________________________________
Signature________________________________________
Must be printed in black ink by: Pres., Sec., Vice-Pres., Treasurer, or Tax Preparer
Must be signed in black ink by: Pres., Sec., Vice-Pres., Treasurer, or Tax Preparer
Due on or before May 1, 2013 – Penalty and interest due after May 1, 2013
You may file this electronically over the internet at
Remittance must accompany this report • Make checks payable to Arkansas Secretary of State
Phone 501-682-3409 or 888-233-0325 (Toll Free)
Mail to: Business and Commercial Services Division • P.O. Box 8014 • Little Rock, Arkansas 72203-8014
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