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Outline

The Arizona Annual Report form is an essential document for businesses operating within the state, particularly those in the utilities sector. This form captures vital information about your company, including its current name, mailing address, and contact details for management and regulatory representatives. It also requires you to disclose any significant changes that occurred during the year, such as ownership shifts or compliance notifications from regulatory bodies. Additionally, the form asks for ownership classification—whether your business is a corporation, partnership, or limited liability company, among others. You'll also need to indicate the counties where you provide services and specify the types of telecommunications services you are authorized to offer. Furthermore, statistical data related to your operations, such as the number of customers and revenue figures, must be reported. Completing this form accurately is crucial, as it helps maintain compliance with state regulations and ensures that your business remains in good standing.

Sample - Arizona Annual Report Form

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
2
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______________________________________________________________________________
3
Statutory Agent:__________________________________________________________________________
(Name)
________________________________________________________________________________________________________________________
(Street) (City) (State) (Zip)
____________________________________________________________________________________________________________
Telephone No. (Include Area Code) Fax No. (Include Area Code Cell 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:_____________________________________________________________________________
Yes __
No __
If yes, please provide specific details in the box below.
Yes __
No __
If yes, please provide specific details in the box below.
Important Changes During the Year
For those companies not subject to the affiliated interest rules, has there been a change in ownership or direct control during
the year?
Has the company been notified by any other regulatory authorities during the year that they are out of compliance?
4
OWNERSHIP INFORMATION
Check the following box that applies to your company:
Sole Proprietor (S) C Corporation (C) (Other than Association/Co-op)
Partnership (P) Subchapter S Corporation (Z)
Bankruptcy (B) Association/Co-op (A)
Receivership (R) Limited Liability Company
Other (Describe)______________________________________________________________________
COUNTIES SERVED
Check the box below for the counties in which you are certificated to provide service:
STATEWIDE
APACHE COCHISE COCONINO
GILA GRAHAM GREENLEE
LA PAZ MARICOPA MOHAVE
NAVAJO PIMA PINAL
SANTA CRUZ YAVAPAI YUMA
5
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
Circuit
Switched
Voice over Internet
Protocol (“VoIP”)
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
__________________________________
Retail
Other
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
$_________________________________
$_________________________________
$_________________________________
Check box if Company is current on payments for:
Regulatory Assessment AZ Universal Service Fund AZ 911/E911 AZ Telephone Relay Service
6
UTILITY SHUTOFFS/DISCONNECTS
MONTH
Termination without Notice
R14-2-509.B
Termination with Notice
R14-2-509.C
OTHER
TOTALS
OTHER (description):
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
7
VERIFICATION
AND
SWORN STATEMENT
Intrastate Revenues Only
VERIFICATION
COUNTY OF (COUNTY NAME)
STATE OF ________________
NAME (OWNER OR OFFICIAL) TITLE
I, THE UNDERSIGNED
COMPANY NAME
OF THE
DO SAY THAT THIS ANNUAL UTILITY REPORT TO THE ARIZONA CORPORATION COMMISSION
MONTH DAY YEAR
FOR THE YEAR ENDING 12 31 2020
HAS BEEN PREPARED UNDER MY DIRECTION, FROM THE ORIGINAL BOOKS,
PAPERS AND RECORDS OF SAID UTILITY; THAT I HAVE CAREFULLY EXAMINED
THE SAME, AND DECLARE THE SAME TO BE A COMPLETE AND CORRECT
STATEMENT OF BUSINESS AND AFFAIRS OF SAID UTILITY FOR THE PERIOD
COVERED BY THIS REPORT IN RESPECT TO EACH AND EVERY MATTER AND
THING SET FORTH, TO THE BEST OF MY KNOWLEDGE, INFORMATION AND
BELIEF.
SWORN STATEMENT
IN ACCORDANCE WITH THE REQUIREMENT OF TITLE 40, ARTICLE 8, SECTION 40-
401, ARIZONA REVISED STATUTES, IT IS HEREIN REPORTED THAT THE GROSS
OPERATING REVENUE OF SAID UTILITY DERIVED FROM ARIZONA INTRASTATE
UTILITY OPERATIONS DURING CALENDAR YEAR 2020 WAS:
Arizona Intrastate Gross Operating Revenues Only ($)
$___________________________
(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 SIGNATURE OF OWNER OR OFFICIAL
DIFFERENCE. (EXPLAIN IN DETAIL)
TELEPHONE NUMBER
SUBSCRIBED AND SWORN TO BEFORE ME
A NOTARY PUBLIC IN AND FOR THE COUNTY OF
THIS DAY OF
(SEAL)
SIGNATURE OF NOTARY PUBLIC
MY COMMISSION EXPIRES____________________________
COUNTY NAME
MONTH 20__
8
VERIFICATION
AND
SWORN STATEMENT
RESIDENTIAL REVENUE
INTRASTATE REVENUES ONLY
STATE OF ARIZONA
I, THE UNDERSIGNED
OF THE
DO SAY THAT THIS ANNUAL UTILITY REPORT TO THE ARIZONA CORPORATION COMMISSION
FOR THE YEAR ENDING
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:
(THE AMOUNT IN BOX AT LEFT
INCLUDES $_____________________________
IN SALES TAXES BILLED, OR COLLECTED)
*RESIDENTIAL REVENUE REPORTED ON THIS PAGE
MUST INCLUDE SALES TAXES BILLED.
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 SIGNATURE OF NOTARY PUBLIC
COUNTY OF (COUNTY NAME)
NAME (OWNER OR OFFICIAL) TITLE
COMPANY NAME
MONTH DAY YEAR
12 31 2020
NOTARY PUBLIC NAME
COUNTY NAME
MONTH 20__
ARIZONA INTRASTATE GROSS OPERATING REVENUES
$_________________________
9
FINANCIAL INFORMATION
Income Statements:
Attach to this annual report a copy of the companys 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.
Docket No. _____________________ Year Ending: 12-31-20
Company Name: ___________________________________________________
10
FIGURE 1A
Account Description $ Amount
Revenues:
Expenses:
Operating Income:
Net Income:
Attachment 1

Form Information

Fact Name Description
Governing Law The Arizona Annual Report form is governed by Arizona Revised Statutes, Title 40.
Filing Deadline The report must be filed annually by March 31st for the previous calendar year.
Required Information Companies must provide updated contact details, ownership information, and services offered.
Consequences of Non-Compliance Failure to file may result in penalties or the suspension of the company's operating authority.

Detailed Guide for Filling Out Arizona Annual Report

Completing the Arizona Annual Report form is essential for maintaining compliance with state regulations. After filling out the form, ensure that all information is accurate and submit it by the designated deadline to avoid any penalties.

  1. Obtain the Arizona Annual Report form from the Arizona Corporation Commission website or your local office.
  2. Review the pre-printed company name on the form. If it is incorrect or missing your "doing business as" (dba) name, make the necessary changes in the designated area.
  3. Fill in your current company name in the "Company Name" section.
  4. Provide your complete mailing address, including street, city, state, and zip code.
  5. Enter your telephone number, fax number, and cell number, including area codes.
  6. Include your email address in the appropriate field.
  7. If applicable, provide a local office mailing address, along with the customer service phone number and website address.
  8. Fill out the management information section, including the name and title of the management contact, along with their contact details.
  9. Complete the regulatory contact section with the necessary details.
  10. Provide the statutory agent's name and contact information.
  11. Include the attorney's name and contact information, if applicable.
  12. Indicate if there were any important changes during the year by checking "Yes" or "No." Provide details if applicable.
  13. Select the ownership type by checking the appropriate box (e.g., Sole Proprietor, Partnership, Corporation, etc.).
  14. Check the boxes for the counties where your company is certificated to provide service.
  15. Mark the services you are authorized to provide by checking the relevant boxes.
  16. Fill in the statistical information section if your company is a telecommunications utility, providing the required data.
  17. Review all information for accuracy and completeness before submission.
  18. Submit the completed form by the deadline to the Arizona Corporation Commission.

Obtain Answers on Arizona Annual Report

  1. What is the purpose of the Arizona Annual Report form?

    The Arizona Annual Report form is a required document for businesses operating in Arizona, particularly utilities. It provides essential information about the company's operations, ownership, and financial status for the previous year. This report helps the Arizona Corporation Commission monitor compliance and assess the company's performance within the regulatory framework.

  2. Who needs to file the Arizona Annual Report?

    Any utility company operating in Arizona must file the Annual Report. This includes various types of businesses, such as corporations, partnerships, and limited liability companies. If your business provides telecommunications services, you are also required to submit this report annually to maintain compliance with state regulations.

  3. What information is required on the form?

    The form requests detailed information, including:

    • Company name and contact details
    • Management and regulatory contacts
    • Ownership structure
    • Counties served
    • Services authorized to provide
    • Statistical information specific to telecommunications

    Providing accurate and up-to-date information is crucial for compliance and regulatory review.

  4. When is the Arizona Annual Report due?

    The Annual Report is typically due by March 31st of each year, covering the previous calendar year ending December 31st. It is essential to submit the report on time to avoid potential penalties or regulatory issues.

  5. What happens if I do not file the Annual Report?

    Failure to file the Arizona Annual Report can result in various consequences, including fines, penalties, or even loss of operating authority. The Arizona Corporation Commission may take enforcement actions against companies that do not comply with filing requirements.

  6. How can I make changes to the pre-printed company name on the form?

    If the pre-printed company name on the form is not current or if your doing business as (DBA) name is missing, you can make changes directly on the form. There is a designated area to list your current company name and DBA. Ensure that any changes are clearly noted to avoid confusion during processing.

Common mistakes

Filling out the Arizona Annual Report form can be a straightforward task, but many individuals make common mistakes that can lead to delays or complications. One significant error is neglecting to update the company name or doing business as (dba) name. The form requires accurate and current information. If the pre-printed name is incorrect, it is essential to click the designated option and provide the correct name. Failing to do so can create confusion and may result in the report being deemed invalid.

Another frequent mistake involves incomplete or incorrect contact information. This includes the mailing address, telephone numbers, and email addresses. Each section must be filled out clearly and accurately. Providing outdated or incorrect contact details can hinder communication with regulatory authorities. This can lead to missed notifications or important updates, which could affect compliance status.

Additionally, many people overlook the importance of disclosing significant changes during the year. The form asks whether there have been changes in ownership or direct control. If the answer is yes, specific details must be provided. Omitting this information could lead to penalties or complications with the regulatory process. Transparency is crucial for maintaining compliance.

Many individuals also fail to check the appropriate ownership box that applies to their company. The form includes several options, such as sole proprietor, partnership, and various types of corporations. Choosing the wrong classification can lead to misunderstandings regarding the company’s regulatory obligations. It is vital to select the correct designation to ensure compliance with Arizona laws.

Another common oversight is not accurately reporting the counties served. The form provides a list of counties where services are provided. If a company operates in multiple counties but fails to check all applicable boxes, it may face regulatory scrutiny. Ensure that all relevant counties are marked to avoid any compliance issues.

Finally, many people neglect to verify the accuracy of statistical information, especially if the company provides telecommunications services. Reporting incorrect figures, such as the total number of customers or revenue generated, can have serious repercussions. It is essential to double-check all numerical data before submission to ensure accuracy and compliance with regulatory standards.

Documents used along the form

When submitting the Arizona Annual Report form, there are several other documents and forms that may be required or beneficial to include. Each of these documents plays a crucial role in ensuring compliance and providing necessary information to the Arizona Corporation Commission. Below is a list of commonly used forms and documents.

  • Articles of Incorporation: This document establishes a corporation's existence in Arizona. It includes essential information such as the company name, purpose, and structure.
  • Bylaws: Bylaws outline the internal rules and procedures for managing a corporation. They cover topics like meetings, voting, and the roles of officers.
  • Operating Agreement: For LLCs, this agreement details the management structure and operating procedures. It defines the rights and responsibilities of members.
  • Certificate of Good Standing: This certificate verifies that a business is compliant with state regulations and has met all filing requirements. It is often needed for various transactions.
  • Tax Identification Number (TIN): A TIN is required for tax purposes. It can be an Employer Identification Number (EIN) or a Social Security Number, depending on the business structure.
  • Annual Financial Statements: These statements provide a summary of the company’s financial performance and are often required for transparency and regulatory compliance.
  • Regulatory Filings: Depending on the type of business, additional regulatory filings may be necessary. These could include reports to state or federal agencies.
  • Change of Address Form: If there has been a change in the business's address, this form should be filed to keep records current and accurate.

It is essential to gather these documents and ensure they are up-to-date when submitting the Arizona Annual Report. Doing so helps maintain compliance and can prevent potential issues down the line. Always consider consulting with a professional if you have questions about the requirements specific to your business.

Similar forms

The Arizona Annual Report form shares similarities with several other important documents. Each serves a unique purpose but contains overlapping information that helps maintain transparency and compliance. Below are four documents that resemble the Arizona Annual Report form:

  • Business License Application: This document requires detailed information about the business, including ownership, contact details, and operational scope. Like the Annual Report, it ensures that businesses comply with local regulations and provides essential information to regulatory authorities.
  • State Tax Registration Form: Similar to the Annual Report, this form collects information about the business's structure, ownership, and operational details. It helps state authorities track businesses for tax purposes and ensures compliance with tax laws.
  • Annual Financial Statement: This document outlines a company's financial performance over the year. Like the Annual Report, it provides insights into the business's operations, revenue, and compliance with financial regulations, ensuring stakeholders have access to relevant financial data.
  • Corporate Bylaws: While primarily focused on governance, corporate bylaws include information about the structure and management of the company. This document, like the Annual Report, is crucial for maintaining transparency and ensuring that all stakeholders are informed about the company's operational framework.

Dos and Don'ts

When filling out the Arizona Annual Report form, keep the following guidelines in mind:

  • Do ensure that your company name is current. If it has changed, update it on the form.
  • Don't leave any required fields blank. Each section must be completed to avoid delays.
  • Do provide accurate contact information for management and regulatory contacts.
  • Don't use abbreviations or shorthand. Write out names and addresses clearly.
  • Do check the box for the services your company is authorized to provide.
  • Don't forget to include your company's total assets and revenue figures.
  • Do review your form for errors before submission. Double-check all numbers and names.
  • Don't submit the form without a signature. It must be signed by an authorized person.
  • Do keep a copy of the completed form for your records.

Misconceptions

Understanding the Arizona Annual Report form is crucial for businesses operating in the state. However, several misconceptions can lead to confusion and potential compliance issues. Here’s a breakdown of nine common misconceptions:

  1. Only Corporations Need to File: Many believe that only corporations are required to submit the Arizona Annual Report. In reality, all business entities, including LLCs and partnerships, must file this report.
  2. Filing is Optional: Some think that filing the Annual Report is optional. This is a misconception. Failing to file can result in penalties, including the potential loss of good standing.
  3. It’s Just a Formality: While it may seem like a routine task, the Annual Report serves as an important update to the state about your business operations and compliance status.
  4. Only Financial Information is Required: Many assume that only financial data needs to be reported. However, the form also requires detailed information about management, ownership, and services provided.
  5. Deadlines Are Flexible: Some businesses mistakenly believe they can submit the report whenever they want. In Arizona, there are strict deadlines, and late submissions can incur fines.
  6. Changes Don’t Need to Be Reported: Businesses may think that if there are no significant changes, they don’t need to update their report. However, any changes in ownership, management, or services must be disclosed.
  7. One Size Fits All: It’s a common misconception that the same report can be used for multiple years. Each year requires a new report reflecting the current status of the business.
  8. Filing is the Only Requirement: Some believe that simply filing the report is enough to stay compliant. In truth, businesses must also meet other regulatory requirements throughout the year.
  9. Assistance is Unnecessary: Finally, many think they can handle the filing without help. Consulting with a legal advisor can provide clarity and ensure that all aspects of the report are correctly completed.

By understanding these misconceptions, businesses can better navigate the requirements of the Arizona Annual Report form and maintain compliance with state regulations.

Key takeaways

  • Ensure the company name is accurate. If the pre-printed name is incorrect, update it before submission.

  • Provide a complete mailing address, including street, city, state, and zip code. This information is crucial for communication.

  • List all management contacts and their details. This includes names, titles, and contact information.

  • Indicate any important changes during the year, such as ownership changes or compliance issues. Transparency is key.

  • Check the appropriate box for your ownership structure. This helps define your business type for regulatory purposes.

  • Identify all counties served by your company. This ensures that your service area is clearly defined.

  • Report on the services authorized to provide. This includes telecommunications services and any additional offerings.