DO NOT WRITE ABOVE THIS LINE; RESERVED FOR ACC USE ONLY.
ORDER FORM
1. PERSON SUBMITTING ORDER – complete the following:
Name:
Phone:
Fax:
2. RETURN DELIVERY OPTIONS – check only one box to indicate how and to whom the item is to be returned and complete
the requested information:
Pick up
Name:
Phone:
Mail
Name
Address 1
Address 2 (optional)
City State Zip
Country
Phone:
Fax Fax:
Phone:
Fax to Name:
3. ITEMS SUBMITTED – list each document or service item submitted, one per line. Give the quantity for each item. Check
the box if the item is expedited and/or a resubmission. List the associated fee for each item. If more space is needed,
complete another Order Form.
Item Description Qty. Expedited Resubmsn. Fee
See the Fee Schedule for Corporations or LLCs for fee information.
Total Fees:
4. PAYMENT
MOD Account MOD Account Holder Name:
MOD Account number: MOD User Name:
ALL OTHER FORMS OF PAYMENT
complete this Order Form. Print the Order Form and each and every document or service request to
be submitted. Checks should be made payable to Arizona Corporation Commission – do not abbreviate. Checks without an imprinted name or
address will not be accepted. Submit all documents together with the Order Form and payment by mail or in person to:
Arizona Corporation Commission – Corporate Filings Section
1300 West Washington Street, 1st floor
Phoenix, Arizona 85007
Once submitted to the A.C.C., this document becomes a public record, however, credit card or account numbers will not be disclosed to the public.
If you have questions, please contact the Customer Service Call Center at 602-542-3026 or (within Arizona only) 800-345-5819.
M001.001 Arizona Corporation Commission – Corporations Division
Rev: 2010 Page 1 of 1
Clear Form
Print Form
DO NOT WRITE ABOVE THIS LINE; RESERVED FOR ACC USE ONLY.
RECORDS REQUEST FORM
THIS FORM MUST BE SUBMITTED WITH AN ORDER FORM.
USE ONE RECORDS REQUEST FORM FOR EACH ENTITY.
Please note that a “document” means all pages in A.C.C. records that are entered under one document
identification number. This means, for example, if you request a copy of a merger, you will get the
Articles of Merger plus any and all other documents submitted with the Articles, because the entire
package is in A.C.C. records under one document id number and is considered to be one document.
1. ENTITY NAME – give the exact name of the entity you want information on:
_____________________________________________________________________________________________
2. RECORDS OR SERVICE REQUESTED – check all boxes that apply to indicate what information you want on the entity you
listed in number 1:
Archival records search - Stock search
(this is a search for very old entities that generally do not appear on A.C.C.
Certified copy of one or more documents – list the documents below (example – Articles of Incorporation, all
Amendments, Annual Report for year 2009) and put the quantity if you want more than one copy of each:
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Uncertified (plain) copy of documents – list the documents below (example – Articles of Incorporation, Annual
Report for year 2008):
_______________________________________________________________________________________________
_______________________________________________________________________________________________
A Certificate (not for copies) - describe what you want the certificate to say, for example, that a particular entity
does not exist in A.C.C. records, or that certain entities merged:
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Certificate of Good Standing.
3. PAYMENT – the fees are listed below. Pre-payment is required. Because the number of pages in older, microfilmed
documents is not readily determinable, we will accept checks written for “not to exceed” a certain amount, for example, “not
to exceed ten dollars and no cents.” Submit payment with the Order Form and this Records/Service Request Form.
Expedited processing is available by adding $35.00 to the fee for any request or service.
FEES (A.R.S.
§§ 10-122, 10-3122, and 29-851)
Archival Records Search - Stock search (not for copies of documents)
$5.00
Certified copy – corporations (per document) $5.00 + 50 cents per page
Certified copy – LLCs (per document) $15.00 + 50 cents per page
Certificate (any type that is not for copies) $10.00
Uncertified or plain copy – corporations (per document) 50 cents per page
Uncertified or plain copy – LLCs (per document) $5.00 + 50 cents per page
*Expedited processing is available by adding $35.00 to the fee for any request or service.
M048.001 Arizona Corporation Commission
Rev: 2010 Page 1 of 1 Corporations Division
computerized records - do not check this if you just want a copy of a document - see the option below.)