Form 803 - Professional Association Annual Statement - Texas Secretary Of State
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803
Form
(Revised 4/04)
Return in Duplicate to:
Secretary of State
P.O. Box 12028
Austin, TX 78711-3697
Professional Association
512 475-2705
Annual Statement
TDD 800 735-2989
Sec. 21, Texas Professional
FAX: 512/463-1425
Association Act
Filing Fee: $35
Year:
File No.
1. The association name is:
2. Its address is:
Address
City
State
Zip Code
3. The address of the registered office is
(Include a street or building address, a P.O. box is not acceptable.)
TX
Address
City
State
Zip Code
4. The name of the registered agent at such address is:
5. The names and addresses of all members of the professional association are:
(Each must be licensed.)
NAME
ADDRESS
(Include city, state, and zip code.)
6. The names and addresses of all directors or executive committee members are:
(Each must be a licensed member listed in item 5.)
NAME
ADDRESS
(Include city, state, and zip code.)
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