Annual Llc Franchise Tax Report Form - Arkansas Secretary Of State - 2012
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Mark Martin
, Arkansas Secretary of State
ANNUAL LLC 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
2.
5.
Correct any information, if needed, in space provided below:
LIMITED LIABILITY COMPANY MANAGEMENT IS:
(Select One)
Tax Contact Name:
MEMBER(S)
MANAGER(S)
Address:
Please provide current names:
Address Line 2:
Manager / Member: __________________________________
City, State, Zip:
Manager / Member: __________________________________
Phone # of Tax Contact:
Manager / Member: __________________________________
E-mail Address:
Manager / Member: __________________________________
Required Information:
Manager / Member: __________________________________
Federal Tax ID#:
Tax Preparer: ______________________________________
3.
___ A
4 & 5
LL OF THE INFORMATION IN SECTIONS
HAS
BEEN VERIFIED AND HAS BEEN FOUND TO BE EXACTLY
’
.
THE SAME AS LAST YEAR
S REPORT
4.
Registered Agent Information:
Name:
Address 1:
Address 2:
City, State, Zip:
Principal Office Information:
Address:
City, State Zip:
A
L
L
C
P
$150.00
T
D
$150.00
LL
IMITED
IABILITY
OMPANIES
AY
OTAL
UE
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 Member/Manager or Tax Preparer (Listed In 5)
Must be printed in ink by Member/Manager or Tax Preparer (Listed In 5)
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 1-888-233-0325 (Toll Free)
Mail to: Business and Commercial Services Division • P.O. Box 8014 • Little Rock, Arkansas 72203-8014
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