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Free Arizona Annual Report Form

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.

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Dos and Don'ts

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.

  • Do ensure that the company name is current and accurately reflects any changes.
  • Do provide complete contact information, including email addresses and phone numbers, for all relevant contacts.
  • Do check the appropriate boxes for ownership type and services provided to avoid confusion.
  • Do include any important changes that occurred during the year, especially regarding ownership or compliance issues.
  • Don't leave any sections blank; incomplete forms can delay processing.
  • Don't forget to review the form thoroughly before submission to catch any errors or omissions.

By following these guidelines, you can ensure that your Arizona Annual Report is filled out correctly and submitted on time.

Key takeaways

Filing the Arizona Annual Report is essential for maintaining compliance. Here are some key takeaways to help you navigate the process:

  • Update Company Information: Ensure that the company name and any doing business as (dba) names are current. If not, make the necessary changes on the form.
  • Provide Accurate Contact Details: Include all relevant contact information for management, regulatory contacts, and the statutory agent. This information is crucial for communication.
  • Ownership Information: Clearly indicate your company’s ownership structure. This includes whether you are a sole proprietor, partnership, corporation, or other entity.
  • Counties Served: Mark all counties where you are authorized to provide services. This ensures accurate representation of your service area.
  • Services Offered: Specify the services your company is authorized to provide. Be thorough to avoid any compliance issues.
  • Statistical Data: Gather and report all required statistical information, especially if you are a telecommunications utility. This data is important for regulatory review.
  • Compliance Notifications: If your company has received any notifications of non-compliance from other regulatory authorities, detail these changes on the report.
  • Payment Status: Indicate if your company is current on all required payments, including regulatory assessments and universal service funds.
  • Review Before Submission: Double-check all entries for accuracy and completeness. Mistakes can lead to delays or compliance issues.

By following these guidelines, you can ensure a smoother filing process and maintain your company’s good standing with the Arizona Corporation Commission.

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What is the Arizona Annual Report form?

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.

Who needs to file the Arizona Annual Report?

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.

What information is required on the form?

The Arizona Annual Report form requires various details, including:

  • Company name and mailing address
  • Management and regulatory contact information
  • Ownership structure
  • Counties served and services authorized
  • Statistical information specific to telecommunications utilities

It is crucial to provide accurate and up-to-date information. Any changes in ownership or compliance status should be noted on the form.

What happens if the Annual Report is not filed on time?

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.

Documents used along the form

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.

  • Articles of Incorporation: This document outlines the basic details of a corporation, including its name, purpose, and structure. It is essential for establishing the corporation's legal existence in Arizona.
  • Bylaws: Bylaws govern the internal management of a corporation. They detail the rules for meetings, voting, and the roles of directors and officers, ensuring that the organization runs smoothly.
  • Operating Agreement: For Limited Liability Companies (LLCs), this document outlines the management structure and operating procedures. It serves as a contract among members, detailing their rights and responsibilities.
  • Certificate of Good Standing: This certificate confirms that a business entity is legally registered and compliant with state regulations. It may be required for certain transactions or when applying for loans.
  • Registered Agent Form: This form designates a registered agent for service of process. The agent acts as the official point of contact for legal documents and must be available during business hours.
  • Financial Statements: Depending on the type of business, financial statements may be required to demonstrate the company’s financial health. This includes balance sheets, income statements, and cash flow statements.

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.

Document Sample

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 _______________________________________________________________

(Street)

__________________________________________________________________________________________

(City)(State)(Zip)

__________________________________________________________1-800-___________________________

Customer Service Phone No. (Include Area Code)

Website address ___________________________________________________________________________

MANAGEMENT INFORMATION

Management Contact:_________________________________________________________________________________

(Name)(Title)

_______________________________________________________________________________________________________________________

(Street)

(City)

(State)

(Zip)

 

 

 

Telephone No. (Include Area Code)

Fax No. (Include Area Code)

Cell No. (Include Area Code)

Email Address______________________________________________________________________________

Regulatory Contact:___________________________________________________________________

(Name)

(Street)

(City)

(State)

(Zip)

 

 

 

Telephone No. (Include Area Code)

Fax No. (Include Area Code)

Cell No. (Include Area Code)

Email Address______________________________________________________________________________

2

Statutory Agent:__________________________________________________________________________

(Name)

________________________________________________________________________________________________________________________

(Street)(City)(State)(Zip)

____________________________________________________________________________________________________________

Telephone No. (Include Area Code)Fax No. (Include Area CodeCell No. (Include Area Code)

Attorney:________________________________________________________________________________

 

 

(Name)

 

 

 

 

 

(Street)

(City)

(State)

(Zip)

_______________________________________________________________________________________________________________________

Telephone No. (Include Area Code)Fax No. (Include Area Code)Cell No. (Include Area Code)

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.

Yes __ No __

Has the company been notified by any other regulatory authorities during the year that they are out of compliance?

If yes, please provide specific details in the box below.

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

VERIFICATION

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

MONTH

DAY

YEAR

12

31

2020

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.

SWORN STATEMENT

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

MONTH

20__

 

 

SIGNATURE OF NOTARY PUBLIC

7

VERIFICATION

AND

SWORN STATEMENT

RESIDENTIAL REVENUE

STATE OF ARIZONA

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

MONTH DAY YEAR

12 31 2020

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.

SWORN STATEMENT

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 $_____________________________

IN SALES TAXES BILLED, OR COLLECTED)

*RESIDENTIAL REVENUE REPORTED ON THIS PAGE MUST INCLUDE SALES TAXES BILLED.

SUBSCRIBED AND SWORN TO BEFORE ME

A NOTARY PUBLIC IN AND FOR THE COUNTY OF

THIS

 

DAY OF

 

 

 

(SEAL)

MY COMMISSION EXPIRES

SIGNATURE OF OWNER OR OFFICIAL

TELEPHONE NUMBER

NOTARY PUBLIC NAME

COUNTY NAME

MONTH

20__

 

 

SIGNATURE OF NOTARY PUBLIC

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

Guidelines on How to Fill Out Arizona Annual Report

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.

  1. Begin by checking the pre-printed company name on the form. If it is incorrect or missing your DBA (Doing Business As) name, make the necessary changes in the designated area.
  2. Fill in your company name and mailing address, including street, city, state, and zip code. Ensure all information is current and accurate.
  3. Provide your telephone numbers (including area code), fax number, cell number, and email address.
  4. If applicable, complete the local office mailing address section with the same details as above.
  5. List the customer service phone number and website address.
  6. In the management information section, enter the name and title of your management contact, along with their complete address and contact details.
  7. Repeat the process for the regulatory contact, including their name and address.
  8. Provide information for your statutory agent, including name, address, and contact details.
  9. Enter the attorney's information if applicable, including their name, address, and contact details.
  10. Indicate whether there have been any important changes during the year. If yes, provide specific details as requested.
  11. Check the appropriate box for your company’s ownership structure, such as Sole Proprietor, Corporation, or LLC.
  12. Mark the counties where you are authorized to provide services. You can choose from the list provided.
  13. Select the services your company is authorized to provide by checking the relevant boxes.
  14. For telecommunications utilities, fill in the statistical information, including the number of customers and revenue details as required.
  15. Finally, check the box if your company is current on payments for various regulatory assessments.

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.

Common mistakes

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.