Florida Annual Report

Business Name *

Document Number *

Address

Principal Business Address *

Principal Business Address

Principal City *

Principal City

Principal State *

Principal State

Principal Country *

Principal Country

Principal Postal Code *

Principal Postal Code

Mailing Address

Business Mailing Address *

Address Same As Principal Address

Address is different from Principal Address

Business Mailing Address

Mailing Address (if different from Principal Address)

Registered Agent Name / Signature

Agent Last Name *

Agent First Name *

Agent Middle Name

Agent Title

-OR-

Business to serve as RA

If there is a change in registered agent, the new agent will need to type their name in the 'Registered Agent Signature' block below to accept the designation of registered agent. RA signature must be an individual name. I am aware that false information submitted in a document to the Department of State constitutes a third degree felony as provided for in s. 817.155 , F.S. If the RA is a business entity, an individual must sign on their behalf. A business entity cannot serve as its own RA.

Registered Agent Signature

Registered Agent Typed Signature

This signature must be that of the individual "signing" this document electronically or be made with the full knowledge and permission of the individual, otherwise it constitutes forgery under s. 831.06 , F.S.

Authorized Representative 1 Title *

Authorized Representative 1 Full Name *

Authorized Representative 1 Address *

Authorized Representative 2 Title

Authorized Representative 2 Full Name

Authorized Representative 2 Address

Authorized Representative 3 Title

Authorized Representative 3 Full Name

Authorized Representative 3 Address

Authorized Representative 4 Title

Authorized Representative 4 Full Name

Authorized Representative 4 Address

Authorized Representative 5 Title

Authorized Representative 5 Full Name

Authorized Representative 5 Address

Authorized Representative 6 Title

Authorized Representative 6 Address

Authorized Representative 6 Full Name

Authorized Representative 7 Title

Authorized Representative 7 Full Name

Authorized Representative 7 Address

Authorized Representative 8 Title

Authorized Representative 8 Full Name

Authorized Representative 8 Address

Authorized Representative 9 Title

Authorized Representative 9 Full Name

Authorized Representative 9 Address

Authorized Representative 10 Title

Authorized Representative 10 Full Name

Authorized Representative 10 Address

Sign & Complete Filing

YES! This is the information I want to report.

Please enter your e-mail address carefully and verify that it is correct. This is the address correspondence pertaining to this filing and future annual report notices will be sent.

Email Address *

I hereby certify that the information supplied with this filing does not qualify for the exemptions contained in Chapter 119, Florida Statutes. I hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under oath; that I am authorized to execute this report as required by Chapter 605, Florida Statutes; I am aware that false information submitted in a document to the Department of State constitutes a third degree felony as provided for in s. 817.155 , F.S.

Digital Signature For The Individual Signing Here *

Clear

Digital Signor's Title *

Digital Signor's Full Name *

This signature must be that of the individual "signing" this document electronically or be made with the full knowledge and permission of the individual, otherwise it constitutes forgery under s. 831.06 , F.S. The individual "signing" this document affirms that the facts stated herein are true.

My FL Corporate Filings is not a governmental organization and are not affiliated in any way with any state, local, or the federal government.
We are a private for-profit business.

Florida Annual Report

Mailing Address

Registered Agent Name / Signature

-OR-

This signature must be that of the individual "signing" this document electronically or be made with the full knowledge and permission of the individual, otherwise it constitutes forgery under s. 831.06 , F.S.

Registered Agent Information

Name And Address of Person(s) Authorized to Manage Limited Liability Company or For Profit Corporation

Sign & Complete Filing

YES! This is the information I want to report.

Please enter your e-mail address carefully and verify that it is correct. This is the address correspondence pertaining to this filing and future annual report notices will be sent.

This signature must be that of the individual "signing" this document electronically or be made with the full knowledge and permission of the individual, otherwise it constitutes forgery under s. 831.06 , F.S. The individual "signing" this document affirms that the facts stated herein are true.

Phone: (833) 962-6854
Email: [email protected]
Monday to Friday 9am to 6pm EST

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Florida Annual Report

Mailing Address

Registered Agent Name / Signature

-OR-

This signature must be that of the individual "signing" this document electronically or be made with the full knowledge and permission of the individual, otherwise it constitutes forgery under s. 831.06 , F.S.

Registered Agent Information

Name And Address of Person(s) Authorized to Manage Limited Liability Company or For Profit Corporation

Sign & Complete Filing

YES! This is the information I want to report.Please enter your e-mail address carefully and verify that it is correct. This is the address correspondence pertaining to this filing and future annual report notices will be sent.

This signature must be that of the individual "signing" this document electronically or be made with the full knowledge and permission of the individual, otherwise it constitutes forgery under s. 831.06 , F.S. The individual "signing" this document affirms that the facts stated herein are true.

Phone: (833) 962-6854Email: [email protected]Monday to Friday 9am to 6pm EST

Terms of ServicePrivacy PolicyFulfillment/Refund Policy

YES! This is the information I want to report.

Please enter your e-mail address carefully and verify that it is correct. This is the address correspondence pertaining to this filing and future annual report notices will be sent.

Phone: (833) 962-6854
Email: [email protected]
Monday to Friday 9am to 6pm EST

Terms of Service
Privacy Policy
Fulfillment/Refund Policy