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                                                                                                                 Filing Number: ___________________
            John Thurston, Arkansas Secretary of State 

            ANNUAL LLC FRANCHISE TAX REPORT 20                                                                           24 
            For the year ending 12/31/2023

Reports and taxes are due on or before         May  ,120             24.  Penalty and interest will be due for reports if the United States Postal 
Service’s postmark is after the deadline. Complete this report online at www.sos.arkansas.gov, or sign in black ink and mail to 
the address listed below. 

1. Business Name and Address: 
                                                                                                          Save Time & File Online  
Name:                                                                                                     Anytime Day Or Night At 

Address:                                                                                                  www.sos.arkansas.gov 

City, State, Zip:
                                                                                             5. Limited Liability Company Management is (Select One):
2. Correct any of the below information, if needed:                                             ☐ MEMBER(S)                      ☐ MANAGER(S)
Tax Contact Name:                                                                            Please provide current names: 

Address:                                                                                     Member/Manager:   
Address 2:
                                                                                             Member/Manager: 
City, State, Zip: 
                                                                                             Member/Manager: 
Phone # of Tax Contact: 
                                                                                             Member/Manager: 
E-mail Address:
                                                                                             Member/Manager: 
                                                                                             Tax Preparer:   

        ALL INFORMATION IN SECTIONS 3-5                                                      Federal Tax ID#: 
                  BELOW REQUIRED
                                                                                             Nature of Business:

3. Registered Agent Information:
Name:
Address:
Address 2:
City, State, Zip:
4.Principal Office Information (in         Arkansas):
Address:
City, State, Zip:

 ALL LIMITED  IABILITY L         OMPANIES C    AYP               $150.00                                                         TOTAL DUE             $150.00 

   I declare, under the penalties of perjury, that the foregoing statements are true to the best of my knowledge and belief. 

   Executed this  ______________ day of _________________________,_____________                                  
                               (Day)                                       (Month)                (Year)  

    Print Name____________________________________________ Signature____________________________________________ 
              Must be printed in black ink by: Member/Manager or Tax Preparer (Listed In 6)      Must be signed in black ink by: Member/Manager or Tax Preparer (Listed In 6)  
            Due on or before May 1, 20                           24 Penalty and interest due after May 1, 20                                  24 
                                               You may file this online at www.sos.arkansas.gov 
                  Remittance must accompany this report • Make checks payable to Arkansas Secretary of State 
                                               Phone: 501-682-3409 or Toll Free: 888-233-0325 
            Mail to: Business and Commercial Services Division • P.O. Box 8014 • Little Rock, Arkansas 72203-8014 
                                                                                                                                                                Rev.    12/23



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      ARKANSAS ANNUAL FRANCHISE TAX REPORT – Limited Liability Company 

                                  DUE ON OR BEFORE MAY 1 

   Mail Payment To:  Business and Commercial Services,   P.O. Box 8014, Little Rock, Arkansas 72203 
            Online Filing, Payment, and Information: www.sos.arkansas.gov 
                       Phone:  501-682-3409 or Toll Free: 888-233-0325 

   WHO  FILES ANNUAL FRANCHISE TAX REPORTS:                   All domestic and foreign corporations, 
   associations, organizations, and companies constituting a separate legal entity of relationship with the 
   purpose  of  obtaining  a  privilege  or  franchise  which  is  not  allowed  to  them  as  individuals  except 
   those exempted  by  A.C.A. §   26-54-102.  The  only  exemptions  are  nonprofit  corporations,  which 
   are  organizations  exempt  from  the  federal  income  tax,  or  organizations  formed  pursuant  to  the 
   Uniform Partnership Act, A.C.A. § 4-46-101 et seq., or the  Uniform Limited Partnership Act, A.C.A. 
   § 4-47-101 et seq.

1. Name of Limited Liability Company: Company name as it appears in the        Articles of Organization for
   Limited Liability Company in Arkansas or the foreign company name as it appears in the     Application for
   Certificate of Registration of Foreign Limited Liability Company.
   a) DOMESTIC LIMITED LIABILITY COMPANY:          A limited liability company that has filed its original
      Articles of Organization for Limited Liability Company in Arkansas.
   b) FOREIGN  LIMITED  LIABILITY  COMPANY:        A  limited  liability  company  that  has  filed  its  original
      articles of organization anywhere other than Arkansas and has qualified to receive a    Certificate of
      Registration in Arkansas.
2. Tax  Contact  Name,  Address,  and  Contact  Information:  Person  or  firm  designated  to  receive  the
   limited liability company’s annual franchise tax reporting notifications. Please provide a name, address,
   phone number, and email address.
   a) RESPONSIBILITY:  Companies not receiving a form by      March 20    must make a written request for
      paper forms. Fillable PDF forms can be downloaded, or franchise taxes can be filed online, through
      the  Secretary  of  State’s  website  at  www.sos.arkansas.gov.  All  companies  must  comply  with  the
      May 1 due date.
   b) REPORTING YEAR: The year in which the report is due.
   c) TAX YEAR: The year ending December 31 preceding the reporting year.
   d) LLC  Franchise  Tax:  Any  unincorporated  association  filed  pursuant  to  A.C.A.  §  4-32-102  must
      complete  all  parts  of  the  franchise  tax  report.  If  this  report  is  timely  filed,  all  limited  liability
      companies are liable for only the $150.00 payment.
   e) TAX COMPUTED IN ERROR:        Underpayment will be billed to the company. Requests for refunds
      must  be  submitted  with  proof  to  the  Secretary  of  State's  Business  and  Commercial  Services
      Division at the above address.
   f) EXTENSIONS:      Acts 1046 and 1140 of 1991 eliminated the opportunity to request an extension.
      ALL REPORTS ARE DUE ON OR BEFORE MAY 1.
   g) FAILURE  TO  FILE  REPORT:    Per  A.C.A.  §  26-54-107  and  114,  corporations  shall  pay  an
      additional penalty plus interest for late filing of the report or late payment of the tax. In order to be
      considered timely, tax reports and payments must be received by the Secretary of State's office no
      later  than  the  close  of  business  on  May  1  or  must  be  postmarked  by  the  United  States  Postal
      Service no later than midnight on May 1. Postage meter dates are not acceptable for the purpose
      of determining the timely receipt of a tax form and/or payment. See A.C.A. § 26-18-105.

                                                                                                    Rev. 12/23



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      Calculate late franchise taxes, interest, and penalties: 
           A.  Original Tax (Due May 1)                         $____________________ 
           B. Late Filing Penalty                            + $25.00
           C. Tax and Penalty total                          = $____________________ 
           D. Interest: (C) x .000274 x (# of Days Deficient)  = $____________________
           E. Total Tax Due: (C)+(D)                         = $____________________ 
      If you have any questions determining your payment and/or late fees, please contact the Secretary 
      of State’s office at 501-682-3409 or Toll Free: 888-233-0325. 
3. Registered Agent Information: The registered agent is a person or entity designated by the company
   to receive any service of legal action or other official communication on its behalf. Many corporations use
   its attorney or a professional corporate service company for this service. The registered agent’s address
   must be a street address in Arkansas, and the agent must be located at that address. A post office box
   or “mail drop” may NOT be used as the registered agent address. For more information on registered
   agents, please refer to A.C.A. § 4-20-101 et seq.
4. Principal Office Information: Address of  the    place of business of the  executive  offices  of the
   Limited Liability Company in Arkansas. 
5. Limited Liability Company Management: Indicate whether the management of the company is vested
   managers or members, and list the name of the members/managers.
   a. Nature of Business: The type of sector or industry to which the corporation belongs.
   b. Federal Tax ID Number - The business federal tax or EIN number issued by the Internal Revenue
      service

SIGNATURE: Limited liability company reports shall be signed in black ink by any manager (if management 
of the limited liability company is vested in one or more managers) or by any member (if management of the 
limited liability company is reserved to members), or the tax preparer for the entity.

ADDITIONAL INFORMATION 

1. AMENDMENTS:       Changes,  such  as  name,  merger,  etc.,  must  be  filed  through  the  Secretary  of  State
   Business  and  Commercial  Services  Division. Notations  on  the  annual  report  form  will  not  suffice.
   Forms for changes may be obtained online at www.sos.arkansas.gov, or by writing or calling the Arkansas
   Secretary of State Business and Commercial Services Division.
2. DISSOLUTION OR WITHDRAWAL: Any company wishing to cease operations must file a dissolution or
   withdrawal document through the Business and Commercial Services of Secretary of State. See above
   for contact information.

                                                                                          Revised 12/23






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