Arkansas Secretary                              of State                 
                                   1401 W. Capitol, Suite 250,                Little Rock, AR 72201
                                                      501-682-3409 • www.sos.arkansas.gov
      Mark           Mar tin 

                                   M E M O R A N D U M

To:   Corporate Customers

From: Secretary of State - Business Services Division 

Date: Permanent Reminder

Subject:  Dissolution or Withdrawal

Please be reminded that corporations must file Franchise Tax Reports and pay applicable taxes for 
each year that they are considered filed with the Arkansas Secretary of State.

Pursuant to Arkansas Code Annotated § 26-54-105 (d)(1), every corporation that dissolves shall be 
required to pay at the time of dissolution the franchise tax for the prior calendar year and pay at the 
time of dissolution the minimum franchise tax for the year in which dissolved or withdrawn. 

Failure to file the Final Tax Report with payment will result in the corporation's inability to 
dissolve or withdraw.

* * For further definition please feel free to contact a Business Services Representative at
(501) 682-3409 or (888) 233-0325.

   FOR OFFICE USE ONLY   CORPORATION AND LIMITED LIABILITY COMPANY 
                                       FINAL FRANCHISE TAX REPORT 
                         To be submitted prior to Dissolution or Withdrawal                                    
                                                                  Mark Martin
                                                               Secretary of State
                                       Business and Commercial Services Division
                                                               1401 W. Capitol, Suite 250
                                                               Little Rock, Arkansas 72201
                                                   (501) 682-3409 or (888) 233-0325
File #                                                         www.sos.arkansas.gov
1.                                                                               1a.

   (Exact Corporate or Limited Liability Company Name as Registered in Arkansas)                               (Name)

                         (Street and Number)                                                                 (Street and Number)

                         (City State and ZIP Code)                                                           (City State and ZIP Code)
1b. Person you wish to have contacted regarding this tax: Name                                                 Phone #
   Address: 

2. Required Information: Please complete with current names                      (Check One)        Foreign    Domestic
   President                                                   3. State of Incorporation/Organization
   Vice-President                                              4. Date of  Incorporation/Organization
   Secretary                                                   5. Date of Organization in Arkansas
   Treasurer                                                                     a. Arkansas Registered Agent
   Controller                                                                    b. Nature of Business
   Chairman of the Board                                       6. Federal ID Number

                                       E-mail Address:

                                                                                 Minimum Tax Due
          1. Corporation with Authorized Stock                                                                                        $150.00

          2. Corporation without Authorized Stock                                                                                     $300.00

          3. Limited Liability Company                                                                                                $150.00

I declare, under the penalties of perjury, that the foregoing statements are true to the best of my knowledge 
and belief. I understand that the statements made herein are under oath, and that knowingly making a false 
statement herein is a Class C felony (A.C.A § 5-53-102) or a Class A misdemeanor (A.C.A. § 5-53-103), or 
both.

State of                                                       County of

FILED this                                         day of                                             ,        .

(Remittance Must Accompany This Report)

Rev. 09/15
                                                               This form must be signed by: Pres., Vice-Pres., Sec., Treasurer, Controller or Tax Preparer