Arkansas Secre t a ry of State
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
CORPORATE FRANCHISE TAX
In order for this corporation to receive its annual corporate franchise tax reporting form, please complete and file with the office of the Secretary of State at the time of incorporation or qualification.
Street address or Post Office Box number
City, State, ZIP
NOTE: This tax is due on or before May 1 of the year following incorporation or qualification in this state.
I understand that knowingly signing a false document with the intent to file with the Arkansas Secretary of State is a Class C misdemeanor and is punishable by a fine up to $100.00 and/or imprisonment up to 30 days.
Authorized Officer (Type or Print)
Authorized Signature of Incorporator, Officer or Agent for the Corporation FT-11 Rev. 4/06