Fillable IN Report IN- Report 48725.FH11 (How to Start a Business)

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IN Report IN- Report 48725.FH11 (How to Start a Business)

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INDIANA BUSINESS ENTITY REPORT
State Form 48725 (R8 / 7-16)
Approved by State Board of Accounts, 2016
SECRETARY OF STATE
BUSINESS SERVICES DIVISION
302 West Washington Street, Room E018
Indianapolis, IN 46204
Telephone: (317) 232-6576
www.sos.in.gov
INSTRUCTIONS: 1. All corporations must complete Sections A-H (Sections G and H are located on the reverse side of this form).
2. All LLCs must complete Sections A-E and Section H.
3. Please TYPE
or PRINT in INK.
4. Make check or money order payable to the Secretary of State.
5. Submit original completed paperwork to: 302 West Washington Street, Room E-018, Indianapolis, IN 46204.
6. File report online with a credit card. Refer to www.sos.in.gov
.
INFORMATION CONTAINED ON THIS PAGE IS NOT PART OF THE PUBLIC RECORD.
Name of business
E-mail address of business (SOS use only)
RETURN DOCUMENTS TO:
Name
Street address, line 1
Street address, line 2
City
State
ZIP code
Telephone number
( )
E-mail address (If different from above – SOS use only)
Reset Form
Page 1 of 2
INDIANA BUSINESS ENTITY REPORT
State Form 48725 (R8 / 7-16)
Approved by State Board of Accounts, 2016
Indiana Code 23-1-18-3
23-17-29-3
23-18-12-3
SECTION A
Current entity name and principal office address (number and street, city, state, and ZIP code)
Please make any changes to address here. *
* Entity name cannot be changed on this report.
SECTION B
Current filing year
Past filing years reported on this form
SECTION C
Date of incorporation / qualification / formation (month, day, year)
State of domicile
SECTION D
(Please check the appropriate type for your corporate entity.)
Business Corporation Professional Corporation Nonprofit Corporation Ag Coop Limited Liability Company
SECTION E
Current registered agent and registered address **
Please make changes to agent and address here.
** P.O. box is not an acceptable address unless accompanied by a rural route number.
SECTION F
Current President or highest officer and address (number and street, city, state, and ZIP code)
Please make changes to officer and address here.
Current Secretary or other officer and address (number and street, city, state, and ZIP code)
Please make changes to officer and address here.
Page 2 of 2
SECTION G
(Please list the name(s) and address(es) of current director(s). If necessary, attach an additional sheet.)
Name of Director Street Address (number and street) City State ZIP Code
SECTION H
(This must be signed by a corporate officer, chairman of the board, registered agent, certified public accountant or
an attorney employed by the entity or by a member of manager of the LLC.)
Required if registered agent information was updated:
By checking the box, the signator(s) represent(s) that the registered agent named in the application has consented to
the appointment of the registered agent.
This document is signed under the penalties of perjury. (Check the fee schedule below.)
Signature Date of signature (month, day, year)
FEE SCHEDULE
FOR-PROFIT CORPORATIONS (Domestic and Foreign) AND LIMITED LIABILITY COMPANIES (Domestic and Foreign)
All above-named entities must file a biennial report with the Secretary of State. The fee is $50.00 for a two-year registration. The report is due in the
anniversary month of registration. Entities registered in an even year must file every even year. Entities registered in an odd year must file every odd year.
NONPROFIT CORPORATIONS
All nonprofit corporations (domestic and foreign) must file a biennial report with the Secretary of State. The fee is $20.00 for a two-year registration.
Nonprofit corporations that were formed January 1 through June 30 will file their first biennial report, with the $20.00 filing fee, in 2017 and in each odd
year going forward. Nonprofit corporations that were formed July 1 through December 31 will file their first biennial report, with the $20.00 filing fee, in
2016. These entities will file their next biennial report in 2018 and in each even year going forward.
LIMITED LIABILITY PARTNERSHIPS AND LIMITED PARTNERSHIPS
These entities do not file corporate reports.
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IN Report IN- Report 48725.FH11 (How to Start a Business)

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Completed 15 July 2020

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