Limited Liability Partnership Annual Report - Ar Secretary Of State - 2016
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1Mark Martin
, Arkansas Secretary of State
LIMITED LIABILITY PARTNERSHIP
ANNUAL REPORT 2016
Report Due April 1
(PLEASE TYPE OR PRINT CLEARLY IN BLACK INK)
The undersigned, pursuant to A.C.A. § 4-46-1003, sets forth the following:
☐ Domestic
☐ Foreign
1. Name of the Limited Liability Partnership:
2. State or jurisdiction under whose laws Limited Liability Partnership is formed:
3. Street Address (Chief Executive Office):
City:
State:
Zip:
Email Address:
4. Street Address (Office in Arkansas, if different than above):
City:
State:
Zip:
5. Agent for Service of Process:
Street Address:
City:
State:
Zip:
Mailing Address (if different than above):
City:
State:
Zip:
6. Tax Contact Name:
Mailing Address:
City:
State:
Zip:
7. Statement of Qualification Date:
8. List of Partners:
General Partner/Partner:
General Partner/Partner:
General Partner/Partner:
General Partner/Partner:
Tax Preparer:
Executed this ______________ day of _________________________, _____________
(Day)
(Month)
(Year)
______________________________________________
_____________________________________________
Signature of Authorizing Officer
Authorizing Officer
(Sign in Black Ink)
(Type or Print in Black Ink)
Business and Commercial Services Division
1401 W. Capitol, Suite 250, Little Rock, Arkansas 72201-1094
Make checks payable to Arkansas Secretary of State
Phone: 501-682-3409 or Toll Free: 888-233-0325
Email: corprequest@sos.arkansas.gov • Website:
Rev. 12/15
Filing Fee: $15.00 – Remittance must accompany this report.
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