Arkansas Secre t a ry of State
Charlie Daniels
State Capitol · Little Rock, Arkansas 72201-1094 501-682-3409 · www.sos.arkansas.gov
Business & Commercial Services, 250 Victory Building, 1401 W. Capitol, Little Rock
Limited Liability Company Franchise Tax
Please Type or Print
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
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Contact person
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Street address or Post Office Box number
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City, State, ZIP
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Telephone number
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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
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Title
Rev. 4/06