North CarolinaAnnual Report
for Business Corporations
NameofCorporation:![](index_images/index1xi2.jpg)
StateofIncorporation: |
FiscalYear Ending: |
SecretaryofStateCorp.IDNumber:![](index_images/index1xi3.jpg)
FederalEmployerIDNumber:![](index_images/index1xi4.jpg)
Check here if information has not changed since most recently filedAnnual Report, complete line 8 only. ![](index_images/index1xi5.jpg)
![](index_images/index1xi6.jpg)
1.Registeredagent®isteredofficemailingaddress |
Agent: |
2.Streetaddress&countyofregisteredoffice
Mailing Address: ![](index_images/index1xi7.jpg)
Street Address:
County: ![](index_images/index1xi9.jpg)
3.Ifregisteredagentchanged,signatureofnewagent:![](index_images/index1xi10.jpg)
(signatureconstitutesconsenttoappointment)
4.Enterprincipalofficeaddresshere:![](index_images/index1xi11.jpg)
5.Enterprincipalofficetelephonenumberhere:![](index_images/index1xi12.jpg)
6.Entername,title,andbusinessaddressofprincipalofficershere:
Name: |
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Title: |
Address: |
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City: |
State: |
Zip: |
Name: |
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Title: |
Address: |
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City: |
State: |
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Name: |
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City: |
State: |
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7.Brieflydescribethenatureofbusiness:![](index_images/index1xi13.jpg)
8.Certification of annual report, must be completed by all corporations
SIGNATURE:(Formmustbesignedbyofficerofcorporation) |
DATE: |
CheckListforNCAnnualReportforBusinessCorporations
(Instructions for the preparation of the Business Annual Report Form, CD - 479)
Thischecklistisincludedtoassistyouinpreparingtheannualreportforyourbusinesscorporation.Pleasetakeafew minutesandreadtheinformationprovided.
1.ThefollowinginformationmustbeprovidedbyeachcorporationfilinganAnnualReportwiththeNorthCarolina DepartmentofRevenue:
A.NameofCorporation
B.StateofIncorporation
C.SecretaryofStateCorp.IDNumber
D.FederalEmployerIDNumber
EffectiveJanuary1,1998andapplyingtotaxyearsendingonorafterDecember31,1997,allcorporationsauthorizedto transactbusinessinNorthCarolinaexceptforinsurancecompanies,limitedliabilitycompanies,nonprofitcorporations, andprofessionalassociationsmustfileaCorporateAnnualReportwiththeDepartmentofRevenueandremitatwenty dollar($20.00)fee.Ifthecorporationinformationrequiredtobeenteredinitem1throughitem7ofFormCD-479has notchangedsincethemostrecentlyfiledannualreport,checktheboxnearthetopoftheform.
2.Whenchangingtheregisteredagentortheregisteredofficemailingaddressinformation,indicatethechangein Item1.Theregisteredagentnamemustbetypedorprinted.TheregisteredofficemailingaddresscanbeaPost OfficeBox.
3.Ifthestreetaddressoftheregisteredofficechanged,indicatethechangeinitem2.Thestreetaddressofthe registeredofficemustbea“StreetAddress”andnota“PostOfficeBox”.
4.Iftheregisteredagenthaschanged,thenewregisteredagentmustsignconsenttotheappointmentinthespace provided.Iftheregisteredagent’snamewaschangedduetomarriage,orbyanyotherlegalmeans,the corporationmustindicatesuchchangeinthespaceprovidedandhavetheagentsignconsenttotheappointment undertheirnewname.
5.Theprincipalofficeaddressshouldrevealthecorporation’sphysicallocation.
6.EntertheprincipalofficetelephonenumberinItem5.
7.Everycorporationmusthaveatleastoneofficer.Ifonlyoneofficerislistedonthereport,itmustbethePresident. Enterthecompletename,title,andbusinessaddressoftheprincipalofficersinItem6.
8.ProvideabriefdescriptionofthenatureofyourbusinessinItem7.Eachcorporationmustprovideabrief descriptionofthenatureofbusinessbeforetheannualreportcanbefiled.
9.ChecktheAnnualReportcarefullytoensureallinformationrequiredforfilinghasbeenprovided.Completethe signature,date,andtypeand/orprintthenameandtitleinthespaceprovidedontheformtocertifythatthe informationisaccurateandcurrent.
For more information or assistance, |
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please contact: |
NCAnnual Report for BC forms are available on the |
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Internet at both the Secretary of State’s Web Site, and at |
Secretary of State |
the Department of Revenue’s Web Site: |
Corporations Division |
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Post Office Box 29525 |
Secretary of State’s Office: www.state.nc.us/secstate |
Raleigh, NC 27626-0525 |
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Phone (919)733-4201 |
Department of Revenue: www.dor.state.nc.us/DOR |
Toll Free 1-(888) 246-7636 |
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