05-102 Texas Franchise Tax Public Information Report
05-102 (Rev.9-15/33)
Texas Franchise Tax Public Information Report
Tcode 13196 Franchise
Professional Associations (PA) and Financial Institutions
Taxpayer number
Report year
You have certain rights under Chapter 552 and 559, Government Code, to review, request and correct information
Taxpayer name Mailing address City
State
ZIP code plus 4
Blacken circle if the mailing address has changed.
Blacken circle if there are currently no changes from previous year; if no information is displayed, complete the applicable information in Sections A, B and C.
Principal place of business
SECTION A
Name Mailing address Name Mailing address Name Mailing address
This report must be signed to satisfy franchise tax requirements.
*1000000000015* *1000000000015* *1000000000015* *1000000000015*
1000000000000
Title
Director
mm d d y y
YES
Term expiration
City
State
ZIP Code
Title
Director
mm d d y y
YES
Term expiration
City
State
ZIP Code
Title
Director
mm d d y y
YES
Term expiration
City
State
ZIP Code
SECTION B
State of formation State of formation
0 percent or more.
Percentage of ownership
Percentage of ownership
SECTION C
Agent:
State of formation (see instructions if you need to make changes)
City
ore in this entity.
Percentage of ownership
State
ZIP Code
sheets for Sections A, B and C, if necessary. The information will be available for public inspection. I declare that the information in this document and any attachments is true and correct to the best of my knowledge and belief, as of the date below, and that a copy of this report has
Title
Date
Area code and phone number
()
-
VE/DE
PIR IND
................
................
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