Arkansas > Secretary Of State > Miscellaneous
Health Spa Consumer Protection Act CFD-03 - Arkansas
| Health Spa Consumer Protection Act Form. This is a Arkansas form and can be used in Miscellaneous Secretary Of State . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
Arkansas Secretary of State Mark Martin Business & Commercial Services, 250 Victory Building, 1401 W. Capitol, Little Rock State Capitol · Little Rock, Arkansas 72201-1094 501-682-3409 · www.sos.arkansas.gov I understand that knowingly signing a false document with the intent to file with the Arkansas Secretary of State is a Class C misdemeanor and is punishable by a fine up to $100.00 and/or imprisonment up to 30 days. NOTE: Subsequent annual reports may be filed within thirty (30) days of the anniversary date of this filing. Health Spa Consumer Protection Act Date: Name of Health Spa: Street Address: (Act 264 of 1989) Annual Registration Statement (Please Submit in Duplicate) The name and addresses of all officers, directors and stockholders of the Health Spa as follows: Name Position Held Address (Attach separate list if necessary) Name of Health Spa's parent corporation, if applicable: Street Address: The names and street addresses of all officers, directors and stockholders of the Health Spa's parent corporation are as follows: Name Position Held Address (Attach separate list if necessary) The types of facilities available are as follows: Name, street address and telephone number of a contact person responsible for filing annual registration: NAME (Signature of Contract Person) STREET ADDRESS (Telephone Number) ADDRESS: City State ZIP CFD-03 Rev. 4/06 American LegalNet, Inc. www.FormsWorkFlow.com
|
|||||||
