Bank Franchise Tax Report - Arkansas Secretary Of State - 2004
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1Charlie Daniels, Arkansas Secretary of State
Franchise Tax Report, 2004 Reporting Year
Annual Report as of December 31, 2003
BANK FRANCHISE TAX REPORT
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: __________________________
Federal Tax ID#
_______________________________
Stock and Asset Information for this reporting year (Required)
DATA FROM CORPORATE BALANCE SHEET:
IMPORTANT: If all assets are not applicable to Arkansas, attach a copy of your balance sheet.
2. TOTAL AUTHORIZED CAPITAL STOCK:
3. ISSUED AND OUTSTANDING CAPITAL STOCK:
(See instruction 9)
(See instruction 10)
NUMBER OF SHARES
PAR VALUE EACH
NUMBER OF SHARES
PAR VALUE EACH
$ TOTAL
*a
$
*a
X $
= $
*b
$
*b
X $
= $
* c
$
* c
X $
= $
NO PAR VALUE =$25 PER SHARE
NO PAR VALUE =$25 PER SHARE
* STATE THE NUMBER OF SHARES IN ALL CLASSES.*
4. Add the Total Column of lines 3a, b and c: and ENTER THE TOTAL ................................... $ ____________
5. Enter the total assets APPLICABLE to ARKANSAS according to the BALANCE SHEET ..... $ ____________
6. Enter the TOTAL ASSETS of the CORPORATION according to the BALANCE SHEET ....... $ ____________
____________ ÷ ÷ ÷ ÷ ____________ = ____________ x
7a.
____________ = ____________
ARKANSAS ASSETS
TOTAL ASSETS
PERCENTAGE
AMOUNT FROM LINE 4
ARKANSAS CAPITAL STOCK
-
ENTER ON LINE 7b
____________ x
_____________
7b.
.0027 =
TAX DUE
MINIMUM TAX DUE $50
Corporations Without Authorized Stock Pay $100.00
ARKANSAS CAPITAL STOCK
IF LESS THAN $50 PAY $50
Due on or before June 1, 2004 -Substantial penalties due after June 1, 2004
State of _______________________ County of __________________________________________
I declare, under the penalties of perjury, that the foregoing statements are true to the best of my knowledge and belief.
FILED this_______day of _______, _______ . Signature _________________________________________
(Day)
(Month)
(Year)
Must be signed in ink by: Pres., Vice-Pres., Sec., Treasurer or Controller
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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