Form 05-102 - Texas Franchise Tax Public Information Report
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CLEAR FORM
05-102
3333
b.
(11-06/26)
a. T Code
This report MUST be filed to
c. Taxpayer identification number
d. Report year
satisfy franchise tax requirements
TEXAS FRANCHISE TAX PUBLIC INFORMATION REPORT
Corporation name and address
Complete a Public Information Report online
1
4
e. PIR / IND
before printing. Begin by entering the 11-digit
taxpayer identification number and 4-digit
Secretary of State file number or, if none,
report year above.
Comptroller unchartered number
g.
Item k on Franchise
Tax Report, Form 05-142
Please mark through any incorrect information, and type or print the correct information.
The following information is required by Section 171.203 of the Tax Code for each corporation or
limited liability company that files a Texas Corporation Franchise Tax Report. Use additional sheets
for Sections A, B, and C, if necessary. The information will be available for public inspection.
Blacken this circle completely if there are currently no changes to the information preprinted in
Section A of this report. Then, complete Sections B and C.
Officer and director
information is reported
Corporation's principal office
as of the date a Public Information Report is
completed. The information is updated annually
as part of the franchise tax report. There is no
Principal place of business
requirement or procedure for supplementing the
information as officers and directors change
throughout the year.
SECTION A. Name, title, and mailing address of each officer and director.
NAME
TITLE
DIRECTOR Term expiration (mm-dd-yyyy)
YES
MAILING ADDRESS
NAME
TITLE
DIRECTOR Term expiration (mm-dd-yyyy)
YES
MAILING ADDRESS
NAME
TITLE
Term expiration (mm-dd-yyyy)
DIRECTOR
YES
MAILING ADDRESS
NAME
TITLE
DIRECTOR Term expiration (mm-dd-yyyy)
YES
MAILING ADDRESS
NAME
TITLE
DIRECTOR Term expiration (mm-dd-yyyy)
YES
MAILING ADDRESS
SECTION B. List each corporation or limited liability company, if any, in which this reporting corporation or limited liability company owns an interest of ten
percent (10%) or more. Enter the information requested for each corporation or limited liability company.
Name of owned (subsidiary) corporation or limited liability company
State of inc./organization
Texas SOS file number
Percentage Interest
Name of owned (subsidiary) corporation or limited liability company
State of inc./organization
Texas SOS file number
Percentage Interest
SECTION C. List each corporation or limited liability company, if any, that owns an interest of ten percent (10%) or more in this reporting corporation or limited
liability company. Enter the information requested for each corporation or limited liability company.
Texas SOS file number
Name of owning (parent) corporation or limited liability company
State of inc./organization
Percentage Interest
Registered agent and registered office currently on file. (See instructions if you need to make changes.)
Agent:
Blacken this circle if you need forms to change the
Office:
registered agent or registered office information.
I declare that the information in this document and any attachments is true and correct to the best of my knowledge and belief, as of the date below, and that a copy of this report has
been mailed to each person named in this report who is an officer or director and who is not currently employed by this, or a related, corporation or limited liability company.
Officer, director, or other authorized person
Title
Date
Daytime phone (Area code and number)
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