Secretary of State Office 500 E Capitol Ave Pierre, SD 57501 (605)773-4845
ANNUAL FARM REPORT
Corporation
Please Type or Print Clearly in Ink No Filing Fee
FILE DATE
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RECEIPT NO ___________________
Clear Form
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Telephone # ____________________ FAX # _______________________
1. Corporate ID, Name and Address:
Search for Corporate ID, Name and Agent
FILING DATE: To be filed with the Annual Report.
2. The name of the South Dakota Registered Agent _______________________________________________________ ______________________________________________________________________________________________
Street Address (Required to be a South Dakota Address) City State ZIP+4
______________________________________________________________________________________________
Mailing Address (Optional Required to be a South Dakota Address) City State ZIP+4
3. List only the changes since the last report of the acreage and location by section, township and county of each lot or parcel of land in this state owned or leased by the corporation. _______________________________________________________________________________________________
County Section Township Acres
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County Section Township Acres
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County Section Township Acres
4. Please complete the appropriate section: Family Farm Corporation
The NUMBER OF SHARES owned by person(s) residing on the farm or actively operating the farm, or who has resided on or has actively operated the farm, or their relatives within the third degree of kindred, or by resident stockholders who are family farmers and are actively engaged in farming as their primary economic activity.
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Authorized Farm Corporation
The PERCENTAGE of gross receipts of the corporation derived from rent, royalties, dividends, interest and annuities.
______________%
5. List any changes to shareholder name, address, number of shares owned, and degree of kindred. ________________________________________________________________________________________________
Name Address City State Zip Shares Kindred
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Name Address City State Zip Shares Kindred
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Name Address City State Zip Shares Kindred
Dated ____________________________
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(Signature of an authorized officer)
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(Printed Name)
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(Title) corporationfarmreport July 2008