Arizona Corporation Annual Report Extension Request Form
In the State of Arizona, if an individual cannot file her/his annual report on time, s/he can request for a six-month deadline extension by submitting a completed version of this form to the Arizona Corporation Commission – Corporate Filings Section. There is no filing fee for this transaction.
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Read the Instructions C002i but payment of the Annual Report fee must be delivered to the A.C.C. wit\ h the Extension Request or the extension will not be granted. Rev: 2010 Page of 1 C002.001 Arizona Corporation Commission – Corporations Di\ vision I ACCEPT Find the A.C.C. file number on the upper corner of filed documents OR on\ our website at: http://www.azcc.gov/Divisions/Corporations By checking the box marked "I accept" below, I acknowledge under penalty of perjury that this document together with any attachments is submitted in compliance with Arizona law. SIGNATURE: By the signature appearing below, the corporation certifies that it is u\ nable to file its annual report on or before the due date, and requests a six (6) month extension of time in which to file its annual report. 4. ANNUAL REPORT FILING FEE - this Extension Request form has no separate filing fee, 3. ANNUAL REPORT DUE DATE (mm/dd/yyyy) : 2. A.C.C. FILE NUMBER: 1. ENTITY NAME - give the exact name of the corporation as shown in A.C.C. records: Please be advised that A.C.C. forms reflect only the minimum provisions required by statute. You should seek private legal counsel \ for those matters that may pertain to the individual needs of your business. All documents filed with the Arizona Corporation Commission are public record and are open for public inspection. If you have questions after reading the Instructions, please call 602-54\ 2-3026 or (within Arizona only) 800-345-5819. REQUIRED - check only one: Filing Fee: None (regular processing) Expedited processing – add $35.00 to filing fee. All fees are nonrefundable - see Instructions. Mail: Arizona Corporation Commission - Corporate Filings Section 1300 W. Washington St., Phoenix, Arizona 85007 Fax: 602-542-4100I am a duly authorized bankruptcy trustee , receiver, or other court-appointed fiduciary for the corporation filing this document. I am the Chairman of the Board of Directors of the corporation filing this document. I am a duly-authorized Officer of the corporation filing this document. Date (mm/dd/yyyy) Printed Name Signature DO NOT WRITE ABOVE THIS LINE; RESERVED FOR ACC USE ONLY. ANNUAL REPORT EXTENSION REQUEST
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