Annual Corporation Franchise Tax Report Non-Stock Corporation - Arkansas Secretary Of State - 2016
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1Mark Martin
000000000
, Arkansas Secretary of State
ANNUAL CORPORATION FRANCHISE TAX REPORT 2016
Non-Stock Corporation
For the year ending 12/31/2015
Reports and taxes are due on or before May 2, 2016. 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 black ink and mail to
the address listed below.
1.
Save Time & File Online
Anytime Day Or Night At
5.
Current Names of Corporate Governors:
President:
2.
Correct any of the below information, if needed:
Vice President:
Tax Contact Name:
Secretary:
Address:
Treasurer:
Address 2:
Controller:
City, State, Zip:
Tax Preparer:
Phone # of Tax Contact:
E-mail Address:
6.
Date of Qualification:
Required Information:
State of Incorporation:
Federal Tax ID#:
Nature of Business:
3.
___ A
4, 5 & 6
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:
Address 2:
City, State, Zip:
Principal Office Information (in Arkansas):
Address:
City, State, Zip:
C
W
A
S
P
$300.00
T
D
$300.00
ORPORATIONS
ITHOUT
UTHORIZED
TOCK
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 black ink by: Pres., Vice Pres., Sec., Treas., Cont., or Tax Preparer
Must be signed in black ink by: Pres., Vice Pres., Sec., Treas., Cont., or Tax Preparer
Due on or before May 2, 2016 – Penalty and interest due after May 2, 2016
You may file this online at
Remittance must accompany this report • Make checks payable to Arkansas Secretary of State
Phone: 501-682-3409 or Toll Free: 888-233-0325
Mail to: Business and Commercial Services Division • P.O. Box 8014 • Little Rock, Arkansas 72203-8014
Rev. 11/14
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