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Annual List Of Subscriber And Resident Agent Of Corporation Sole - Nevada
| Annual List Of Subscriber And Resident Agent Of Corporation Sole Form. This is a Nevada form and can be used in Corporation Secretary Of State . |
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FILE NUMBER (CORPORATION SOLE) ANNUAL LIST OF SUBSCRIBER AND RESIDENT AGENT OF (Name of Corporation Sole) FOR THE FILING PERIOD OF .TO . The corporations duly appointed resident agent in the State of Nevada upon whom process can be served is: CHECK BOX IF YOU REQUIRE A FORM TO UPDATE YOUR RESIDENT AGENT INFORMATION Important: Read instructions before completing and returning this form. THE ABOVE SPACE IS FOR OFFICE USE ONLY 1. Print or type names and addresses, either residence or business, of subscriber or successor submitting the list . Subscriber or successor must sign the form. FORM WILL BE RETURNED IF UNSIGNED 2. If there are additional subscribers attach a list of them to this form. 3. Return the completed form with the $25.00 filing fee. A $50.00 penalty must be added for failure to file this form by the deadline. An annual list received more than 90 days before its due date shall be deemed an amended list for the previous year. 4. Make your check payable to the Secretary of State. Your cancelled check will constitute a certificate to transact business. To receive a certified copy, enclose an additional $30.00 and appropriate instructions. 5. Return the completed form to: Secretary of State, 202 North Carson Street, Carson City, NV 89701-4201, (775) 684-5708. 6. Form must be in the possession of the Secretary of State on or before the last day of the month in which it is due. (Postmark date is not accepted as receipt date.) Forms received after due date will be returned for additional fees and penalties. FILING FEE: $25.00 LATE PENALTY: $50.00 SUBSCRIBER/SUCCESSOR _________________________________________________________________________ _______________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________ ______ NAME TITLE _________________________________________________________________________ _______________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________ ______ ADDRESS CITY ST ZIP I declare, to the best of my knowledge under penalty of perjury, that the above mentioned entity has complied with the provisions of NRS 360.780 and acknowledge that pursuant to NRS 239.330, it is a category C felony to knowingly offer any false or forged instrument for filing in the Office of the Secretary of State. X Signature of Subscriber or Successor Title Date Nevada Secretary of State Form ANNUAL LIST-CORP SOLE 2003 Revised on: 09/29/03 <<<<<<<<<********>>>>>>>>>>>>> 2 DEAN HELLER Instructions for Secretary of State 202 North Carson Street Annual List and Resident Agent Carson City, Nevada 89701-4201 (775) 684 5708 Form Website: secretaryofstate.biz IMPORTANT: READ ALL INSTRUCTIONS CAREFULLY BEFORE COMPLETING FORM. ATTENTION: Pursuant to NRS, the Annual List and Resident Agent form MUST be in the care, custody and control of the Secretary of State by the close of business on the last day of the anniversary month of the original filing. Example: If the entity organized on October 15, 1997 the list must be filed by October 31st of each year. (Postmark date is not accepted as receipt date in the Office of the Secretary of State.) As of November 1, 2003 the annual filing fee will be based on the total number of shares provided for in the articles. Annual lists for nonprofit corporations without shares are $25.00. See fee schedule or contact our office. TYPE or PRINT the following information on the Annual List: 1. The FILE NUMBER and NAME of the entity EXACTLY as it is registered with this office. 2. The FILING PERIOD is the month and year of filing TO the month and year 12 months from that date. Example: if the entity da te was 1/12/99 the filing period would be 1/1999 to 1/2000. 3. The name and address of the RESIDENT AGENT and OTHER names and addresses as required on the list should be entered in the boxes provided on the form. Limited-Liability Companies MUST indicate whether MANAGER or MEMBER is being listed. 4. The SIGNATURE , including his/her title and date signed MUST be included in the areas provided at the bottom of the form. 5. Completed FORM, FEES and applicable PENALTIES must be returned to the Secretary of State. Pursuant to NRS 225.085, all Initial and Annual Lists must be in the care, custody and control of the Secretary of State by the close of the busin ess on the due date. Lists received after the due date will be returned unfiled, and will require any asso ciated fees and penalties as a result of being late. Trackable delivery methods such as Express Mail, Federal Express, UPS Overnight may be acceptable if the package was guaranteed to be delivered on or before the due date yet failed to be timely delivered. ADDITIONAL FORMS may be obtained through our document-on-demand service at 800-583-9486, on our website at http://secretaryofstate.b oizr by calling 775-684-5708. FILE STAMPED COPIES: If you wish to receive a file stamped copy, submit a duplicate copy of the list and appropriate instructions. CERTIFIED COPIES: If you wish to receive a certified copy, enclose an additional $30. 00 per certification and appropriate instructions. EXPEDITE FEE: Filing may be expedited for an additional $75.00 fee. NOTE: The Las Vegas Satellite Office will only accept expedited filings. Regular filings should be sent to the Carson City address. Filing may be submitted at the office of the Secretary of State or by mail at the following addresses: (Regular and Expedited Filings Accepted) (Expedited Filings Only) Secretary of State Secretary of State-Satellite Office Status Division Commercial Recordings Division 202 N. Carson Street 555 E. Washington Avenue, Suite 4000 Carson City, NV 89701-4201 Las Vegas, NV 89101 775-684-5708 Fax 775-684-7123 702-486-2880 Fax 702-486-2888 Nevada Secretary of Stat e Form ANNUAL LIST INST 2003 Revised on: 11/25/03
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