FOR OFFICE USE ONLY
File #
CORPORATION AND LIMITED LIABILITY COMPANY
FINAL FRANCHISE TAX REPORT
To be submitted prior to Dissolution or Withdrawal
John Thurston
Secretary of State
Business and Commercial Services Division
1401 W. Capitol, Suite 250
Little Rock, Arkansas 72201
(501) 682-3409 or (888) 233-0325
www.sos.arkansas.gov
1.
(Exact Corporate or Limited Liability Company Name as Registered in Arkansas)
(Street and Number)
1a.
(Name)
(Street and Number)
(City State and ZIP Code)
1b. Person you wish to have contacted regarding this tax: Name
Address:
(City State and ZIP Code)
Phone #
2. Required Information: Please complete with current names
President
Vice-President
Secretary
Treasurer
Controller
Chairman of the Board
(Check One) Foreign Domestic
3. State of Incorporation/Organization
4. Date of Incorporation/Organization
5. Date of Organization in Arkansas
a. Arkansas Registered Agent
b. Nature of Business
6. Federal ID Number
Minimum Tax Due
1. Corporation with Authorized Stock
$150.00
2. Corporation without Authorized Stock
$300.00
3. Limited Liability Company $150.00
County of
day of
,
.
This form must be
signed
by: Pres., Vice-Pres., Sec., Treasurer, Controller or Tax Preparer
E-mail Address:
I declare, under the penalties of perjury, that the foregoing statements are true to the best of my knowledge
and belief. I understand that the statements made herein are under oath, and that knowingly making a false
statement herein is a Class C felony (A.C.A § 5-53-102) or a Class A misdemeanor (A.C.A. § 5-53-103), or
both.
State of
FILED this
(Remittance Must Accompany This Report)
Rev. 11/18
