The Arizona Annual Report form is a crucial document that businesses in Arizona must file to provide updated information to the Arizona Corporation Commission. This form helps ensure that the Commission has accurate records about a company's operations, management, and services. Completing the annual report is essential for maintaining compliance and transparency in business practices.
Filling out the Arizona Annual Report form can be a straightforward process if you keep a few key points in mind. Below is a list of dos and don'ts to help guide you through this important task.
By following these guidelines, you can ensure that your Arizona Annual Report is filled out correctly and submitted on time.
Filing the Arizona Annual Report is essential for maintaining compliance. Here are some key takeaways to help you navigate the process:
By following these guidelines, you can ensure a smoother filing process and maintain your company’s good standing with the Arizona Corporation Commission.
The Arizona Annual Report form is a document that businesses must submit to the Arizona Corporation Commission. It provides important information about the company's operations, management, and financial status for the previous year. The report is essential for maintaining good standing with the state and ensuring compliance with regulatory requirements.
All businesses registered in Arizona, including corporations, limited liability companies, and partnerships, are required to file the Annual Report. This includes both for-profit and non-profit organizations. If your company is providing regulated services, such as telecommunications, you must also include specific operational data in your report.
The Arizona Annual Report form requires various details, including:
It is crucial to provide accurate and up-to-date information. Any changes in ownership or compliance status should be noted on the form.
If the Arizona Annual Report is not filed by the deadline, your company may face penalties. These can include late fees and potential loss of good standing with the state. In some cases, failure to file can lead to administrative dissolution of the business. Therefore, it is important to submit the report on time to avoid any negative consequences.
When filing the Arizona Annual Report, several other forms and documents may be required or beneficial to ensure compliance with state regulations. Understanding these documents can help streamline the reporting process and maintain good standing with the Arizona Corporation Commission.
Being aware of these additional documents can help businesses navigate the requirements associated with the Arizona Annual Report. Keeping these forms updated and readily available contributes to maintaining compliance and supports the overall success of the business.
Tax Id Number Arizona - Applicants can also indicate if they are veteran-owned businesses, which may be relevant for certain contracting opportunities.
How to File Probate in Arizona - After completing the affidavit, follow the procedures provided in the packet.
Az Tpt Form - Email and contact information for the business must be provided for communication purposes.
ARIZONA CORPORATION COMMISSION
UTILITIES DIVISION
ANNUAL REPORT MAILING LABEL – MAKE CHANGES AS NECESSARY
Please click here if pre-printed Company name on this form is not your current Company name or dba name is not included.
Please list current Company name including dba here:
__________________________________________________________________________
ANNUAL REPORT
FOR YEAR ENDING
12
31
2020
FOR COMMISSION USE
ANN 03
20
COMPANY INFORMATION
Company Name (Business Name) _________________________________________________________
Mailing Address ____________________________________________________________________________
(Street)
_________________________________________________________________________________________
(City)(State)(Zip)
__________________________________________________________________________________________
Telephone No. (Include Area Code)Fax No. (Include Area Code)Cell No. (Include Area Code)
Email Address______________________________________________________________________________
Local Office Mailing Address _______________________________________________________________
__________________________________________________________1-800-___________________________
Customer Service Phone No. (Include Area Code)
Website address ___________________________________________________________________________
MANAGEMENT INFORMATION
Management Contact:_________________________________________________________________________________
(Name)(Title)
_______________________________________________________________________________________________________________________
(City)
(State)
(Zip)
Telephone No. (Include Area Code)
Fax No. (Include Area Code)
Cell No. (Include Area Code)
Regulatory Contact:___________________________________________________________________
(Name)
2
Statutory Agent:__________________________________________________________________________
________________________________________________________________________________________________________________________
(Street)(City)(State)(Zip)
____________________________________________________________________________________________________________
Telephone No. (Include Area Code)Fax No. (Include Area CodeCell No. (Include Area Code)
Attorney:________________________________________________________________________________
Email Address:_____________________________________________________________________________
Important Changes During the Year
Yes __ No __
For those companies not subject to the affiliated interest rules, has there been a change in ownership or direct control during the year?
If yes, please provide specific details in the box below.
Has the company been notified by any other regulatory authorities during the year that they are out of compliance?
3
OWNERSHIP INFORMATION
Check the following box that applies to your company:
Sole Proprietor (S)
Partnership (P)
Bankruptcy (B)
Receivership (R)
CCorporation (C) (Other than Association/Co-op) Subchapter S Corporation (Z)
Association/Co-op (A) Limited Liability Company
Other (Describe)______________________________________________________________________
COUNTIES SERVED
Check the box below for the counties in which you are certificated to provide service:
STATEWIDE
APACHE
GILA
LA PAZ
NAVAJO
SANTA CRUZ
COCHISE
GRAHAM
MARICOPA
PIMA
YAVAPAI
COCONINO
GREENLEE
MOHAVE
PINAL
YUMA
4
SERVICES AUTHORIZED TO PROVIDE
Check the following box(es) for the services that you are authorized to provide:
Resold Long Distance/Interexchange Telecommunications Services (RLD) Resold Local Exchange Telecommunications Services (RLEC)
Facilities-Based Long Distance/Interexchange Telecommunications Services (IXC) Facilities Based Local Exchange Telecommunications Services (CLEC)
Facilities Based Private Line Telecommunications Services Alternative Operator Service Provider
Other (Specify)______________________________________________________________________
STATISTICAL INFORMATION
TELECOMMUNICATION UTILITIES ONLY
Total number of residential local exchange access lines
Total number of residential local exchange customers
Total number of business local exchange access lines
Total number of business local exchange customers
Total quantity of phone numbers assigned to Company
Total phone numbers assigned to Customers by Company
Total number of long distance residential customers
Total number of long distance business customers
Total intrastate local exchange revenue from Arizona operations
Total intrastate long distance/interexchange revenue from Arizona operations Total intrastate revenue from Arizona operations
Total intrastate income from Arizona operations
Value of Company’s total assets in Arizona Value of Company’s total assets
(Value of Company’s total assets in Arizona)/(Value of company’s total assets)
Current amount of deposits, prepayments, and advances from customers
(not including monthly service bills)
Current amount of performance bond
Current amount of Irrevocable Sight Draft Letter of Credit
Check box if Company is current on payments for:
Regulatory Assessment
AZ Universal Service Fund
AZ 911/E911
Circuit
Voice over Internet
Switched
Protocol (“VoIP”)
_______________
________________
__________________________________
RetailOther
_______________ ________________
$_________________________________
%_________________________________
AZ Telephone Relay Service
5
UTILITY SHUTOFFS/DISCONNECTS
MONTH
Termination without Notice
R14-2-509.B
Termination with Notice
R14-2-509.C
OTHER
TOTALS →
OTHER (description):
6
VERIFICATION
AND
SWORN STATEMENT
STATE OF ________________
I, THE UNDERSIGNED OF THE
Intrastate Revenues Only
COUNTY OF (COUNTY NAME)
NAME (OWNER OR OFFICIAL) TITLE
COMPANY NAME
DO SAY THAT THIS ANNUAL UTILITY REPORT TO THE ARIZONA CORPORATION COMMISSION
FOR THE YEAR ENDING
DAY
YEAR
HAS BEEN PREPARED UNDER MY DIRECTION, FROM THE ORIGINAL BOOKS, PAPERS AND RECORDS OF SAID UTILITY; THAT I HAVE CAREFULLY EXAMINED THE SAME, AND DECLARE THE SAME TO BE A COMPLETE AND CORRECT STATEMENT OF BUSINESS AND AFFAIRS OF SAID UTILITY FOR THE PERIOD COVERED BY THIS REPORT IN RESPECT TO EACH AND EVERY MATTER AND THING SET FORTH, TO THE BEST OF MY KNOWLEDGE, INFORMATION AND BELIEF.
IN ACCORDANCE WITH THE REQUIREMENT OF TITLE 40, ARTICLE 8, SECTION 40- 401, ARIZONA REVISED STATUTES, IT IS HEREIN REPORTED THAT THE GROSS OPERATING REVENUE OF SAID UTILITY DERIVED FROM ARIZONA INTRASTATE UTILITY OPERATIONS DURING CALENDAR YEAR 2020 WAS:
Arizona Intrastate Gross Operating Revenues Only ($)
$___________________________
(THE AMOUNT IN BOX ABOVE
INCLUDES $_________________
IN SALES TAXES BILLED, OR COLLECTED)
**REVENUE REPORTED ON THIS PAGE MUST INCLUDE SALES TAXES BILLED OR COLLECTED. IF FOR ANY OTHER REASON, THE REVENUE REPORTED ABOVE DOES NOT AGREE WITH TOTAL OPERATING REVENUES ELSEWHERE REPORTED, ATTACH THOSE STATEMENTS THAT RECONCILE THE DIFFERENCE. (EXPLAIN IN DETAIL)
SIGNATURE OF OWNER OR OFFICIAL
TELEPHONE NUMBER
SUBSCRIBED AND SWORN TO BEFORE ME
A NOTARY PUBLIC IN AND FOR THE COUNTY OF
THIS
DAY OF
(SEAL)
MY COMMISSION EXPIRES____________________________
COUNTY NAME
20__
SIGNATURE OF NOTARY PUBLIC
7
RESIDENTIAL REVENUE
STATE OF ARIZONA
I, THE UNDERSIGNED
OF THE
INTRASTATE REVENUES ONLY
NAME (OWNER OR OFFICIAL)
TITLE
MONTH DAY YEAR
12 31 2020
IN ACCORDANCE WITH THE REQUIREMENTS OF TITLE 40, ARTICLE 8, SECTION 40- 401.01, ARIZONA REVISED STATUTES, IT IS HEREIN REPORTED THAT THE GROSS OPERATING REVENUE OF SAID UTILITY DERIVED FROM ARIZONA INTRASTATE UTILITY OPERATIONS RECEIVED FROM RESIDENTIAL CUSTOMERS DURING CALENDAR YEAR 2020 WAS:
ARIZONA INTRASTATE GROSS OPERATING REVENUES
$_________________________
(THE AMOUNT IN BOX AT LEFT INCLUDES $_____________________________
*RESIDENTIAL REVENUE REPORTED ON THIS PAGE MUST INCLUDE SALES TAXES BILLED.
MY COMMISSION EXPIRES
NOTARY PUBLIC NAME
8
FINANCIAL INFORMATION
Income Statements:
Attach to this annual report a copy of the company’s year-end (Calendar Year 2020) financial statements.
Alternative templates are provided for this information. Please select one from Figure 1A, Figure 1B or Figure 1C.
(All Facilities-Based CLECs, Facilities-Based IXCs, Facilities-Based Access Line Providers & Facilities-Based Private Line Providers must submit FIGURE 1C)
Arizona Administrative Code, R14.2.1115.F, states that one of the items required in this Annual Report is a statement of income for the reporting year
Balance Sheets:
Alternative templates are provided for this information. Please select one from Figure 2A or Figure 2B.
(All Facilities-Based CLECs, Facilities-Based IXCs, Facilities-Based Access Line Providers & Facilities-Based Private Line Providers must submit FIGURE 2B)
Arizona Administrative Code, R14.2.1115.F, states that one of the items required in this Annual Report is a balance sheet as of the end of the reporting year
ALL INFORMATION MUST BE ARIZONA-SPECIFIC AND REFLECT OPERATING
RESULTS IN ARIZONA.
9
Docket No. _____________________Year Ending: 12-31-20
Company Name: ___________________________________________________
FIGURE 1A
Account Description
$ Amount
Revenues:
Expenses:
Operating Income:
Net Income:
Attachment 1
10
Filling out the Arizona Annual Report form is an important step for businesses operating in the state. This report provides essential information about your company, including ownership details and services offered. Follow the steps below to ensure accurate completion of the form.
Once you have completed the form, review all entries for accuracy. It’s essential to ensure that all information is correct before submission. After verifying the details, you can submit the report as instructed on the form.
Filling out the Arizona Annual Report form is an important task for businesses, but mistakes can happen easily. One common error is failing to update the company name or doing business as (dba) name. If the name on the form does not match the current name, it can lead to complications. Always ensure that the name is accurate before submitting the report.
Another frequent mistake involves incomplete contact information. It's essential to provide a complete mailing address, including street, city, state, and zip code. Omitting any part of this information can delay communication from the Arizona Corporation Commission. Double-check that all phone numbers, including area codes, are included as well.
People often forget to designate a statutory agent. This agent is responsible for receiving legal documents on behalf of the company. Not including this information can create issues if the company needs to be contacted for legal matters. Be sure to fill out the statutory agent section completely.
Errors in ownership information can also pose significant problems. When checking the appropriate box for the type of business entity, it's crucial to choose the correct designation, whether it’s a sole proprietor, partnership, or corporation. Misclassification can lead to regulatory issues, so take care to select the right option.
Another common mistake is not providing details about any important changes that occurred during the year. If there were changes in ownership or compliance notifications from regulatory authorities, these must be reported accurately. Failing to disclose this information can result in penalties or additional scrutiny from the Commission.
Many people overlook the statistical information section, which is particularly important for telecommunications utilities. Providing accurate data about access lines, customers, and revenues is essential. Inaccurate figures can lead to misinterpretations of the company's operations and may affect regulatory assessments.
Additionally, some individuals neglect to check the boxes for services authorized to provide. This section is critical as it outlines what services the company is legally allowed to offer. Not completing this section can lead to confusion about the company's capabilities and compliance.
Finally, a common oversight is not reviewing the entire form before submission. Taking a moment to read through the completed form can help catch any mistakes or omissions. A careful review can save time and prevent potential issues with the Arizona Corporation Commission.