Annual Bank Franchise Tax Report - Arkansas Secretary Of State - 2012
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Mark Martin, Arkansas Secretary of State
ANNUAL BANK FRANCHISE TAX REPORT 2012
For the year ending 12/31/2011
Reports and taxes are due on or before May 1, 2012. 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
Anytime Day Or Night At
Correct any information, if needed, in space provided below:
2.
7.
State of:___________________________________________
Tax Contact Name:
County of: _________________________________________
Address:
Date of Qualification: ________________________________
Address Line 2:
City, State, Zip:
Phone # of Tax Contact:
E-mail Address:
Required Information:
Federal Tax ID#:
3.
___ A
4, 5, 6 & 7
LL OF THE INFORMATION IN SECTIONS
HAS BEEN VERIFIED AND HAS BEEN FOUND TO BE EXACTLY
’
.
THE SAME AS LAST YEA R
S REPORT
4.
TOTAL AUTHORIZED CAPITAL STOCK
(See Instruction 9)
NUMBER OF SHARES
PAR VALUE EACH
*a
$
*b
$
*c
$
NO PAR VALUE =$25 PER SHARE
5.
ISSUED AND OUTSTANDING CAPITAL STOCK
(See Instruction 10)
NUMBER OF
PAR VALUE EACH
TOTAL
SHARES
*a
X $
= $
*b
X $
= $
*c
X $
= $
No PV=$25 per share
*d
(Add 5a +5b + 5c) TOTAL:
= $
6.
ARKANSAS ASSETS ÷
TOTAL ASSETS =
PERCENTAGE
X AMOUNT FROM LINE 5D = ARKANSAS CAPITAL STOCK
X .003 =
TAX DUE
MINIMUM TAX DUE $150 • IF LESS THAN $150 PAY $150 • BANKS 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 ink by: Pres., Sec., Vice-Pres., Treasurer, or Tax Preparer
Must be signed in ink by: Pres., Sec., Vice-Pres., Treasurer, or Tax Preparer
Due on or before May 1, 2012 – Penalty and interest due after May 1, 2012
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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