In order for this limited liability company to receive its annual franchise tax reporting form,
please complete and file with the Office of the Secretary of State at the time of filing.
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Limited Liability Company name as used in Arkansas Contact person
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Street address or Post Office Box number City, State, ZIP
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Telephone number E-mail address
NOTE:
This tax is due on or before May 1 of the year following filing or qualification in
this state.
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__________________________
Signature
Title
Please Type or Print
Limited Liability Company Franchise Tax
Arkansas Secretary of State
1401 W. Capitol, Suite 250, Little Rock, AR 72201
John Thurston
501-682-3409 • www.sos.arkansas.gov
Rev. 11/18