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The Arizona Annual Report form is a critical document for businesses operating within the state, particularly those in the utilities sector. Each year, companies must provide updated information to the Arizona Corporation Commission, ensuring transparency and compliance. This form requires essential details such as the company's name, mailing address, and contact information, including telephone numbers and email addresses. Additionally, it collects management and ownership information, which is vital for regulatory oversight. Companies must also indicate any significant changes that occurred during the year, such as changes in ownership or regulatory compliance issues. The report further requires businesses to specify the counties they serve and the services they are authorized to provide, whether telecommunications or other utilities. Statistical data regarding customer numbers, revenue, and assets must also be reported, painting a comprehensive picture of the company's operations. Completing this form accurately is not just a legal obligation; it is also an opportunity for companies to demonstrate their commitment to good governance and accountability.

Arizona Annual Report Example

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

File Breakdown

Fact Name Fact Details
Governing Law The Arizona Annual Report form is governed by Arizona Revised Statutes (ARS) § 40-204.
Filing Frequency Utilities are required to file the annual report once a year, typically by December 31.
Company Information The form collects essential company details, including the business name and mailing address.
Management Contact Companies must provide information about their management contact, including name and title.
Ownership Information Filing entities must indicate their ownership structure, such as sole proprietorship or corporation.
Counties Served The form requires companies to list the counties in which they are authorized to provide services.
Services Authorized Companies must specify the types of telecommunications services they are authorized to provide.
Statistical Information Telecommunication utilities are required to report various statistical data, including customer numbers and revenue.
Important Changes Companies must disclose any significant changes in ownership or compliance notifications from regulatory authorities.

Guide to Using Arizona Annual Report

Completing the Arizona Annual Report form is an essential task for businesses operating within the state. This process involves providing detailed information about the company, its management, and its operations. After filling out the form, you will need to submit it to the Arizona Corporation Commission to ensure compliance with state regulations.

  1. Obtain the Arizona Annual Report form from the Arizona Corporation Commission's website or your local office.
  2. Check the pre-printed company name on the form. If it is incorrect or your doing business as (dba) name is missing, click the designated area to make changes and write the correct name in the provided space.
  3. Fill in the company information section, including the business name, mailing address, and contact numbers (telephone, fax, cell). Ensure that the email address is also included.
  4. If applicable, provide the local office mailing address, customer service phone number, and website address.
  5. In the management information section, enter the name and title of the management contact, followed by their complete address and contact details.
  6. Provide information for the regulatory contact in the same manner as the management contact.
  7. List the statutory agent’s name and address, including their contact information.
  8. If you have an attorney, fill in their name, address, and contact details as well.
  9. Indicate whether there have been any important changes during the year by checking "Yes" or "No." If there were changes in ownership or compliance notifications, provide specific details in the designated box.
  10. Choose the appropriate ownership type for your company by checking the corresponding box (e.g., Sole Proprietor, Partnership, Corporation, etc.).
  11. Select the counties where your company is certified to provide services by checking the relevant boxes.
  12. Mark the services your company is authorized to provide by checking the applicable boxes.
  13. For telecommunication utilities, complete the statistical information section by providing the total numbers and values requested, such as access lines, customers, and revenue figures.
  14. Check the box if your company is current on payments for regulatory assessments and other fees.
  15. Review all the information for accuracy and completeness before submission.
  16. Submit the completed form to the Arizona Corporation Commission by the designated deadline.

Get Answers on Arizona Annual Report

What is the purpose of the Arizona Annual Report form?

The Arizona Annual Report form serves as a crucial tool for businesses operating within the state. It provides the Arizona Corporation Commission with essential information regarding a company’s operations, ownership, and compliance status. By submitting this report, companies ensure they remain in good standing and adhere to state regulations. This form helps maintain transparency and accountability in the business sector, which ultimately benefits consumers and the economy as a whole.

Who needs to file the Arizona Annual Report?

Any business entity that is registered to operate in Arizona must file the Annual Report. This includes various types of organizations such as corporations, limited liability companies (LLCs), partnerships, and cooperatives. If your business is involved in providing utility services, you will have additional requirements to fulfill in the report. Failing to file on time can result in penalties or even the suspension of your business license, so it’s essential to stay on top of this obligation.

What information is required on the Annual Report form?

The Arizona Annual Report form requires a variety of information to ensure the Commission has an accurate understanding of your business. Key sections include:

  1. Company Information: This includes your current business name, mailing address, contact numbers, and email address.
  2. Management Information: You will need to provide details about your management team, including names, titles, and contact information.
  3. Ownership Information: Indicate your business structure (e.g., corporation, partnership) and any changes in ownership during the year.
  4. Counties Served: List the counties in Arizona where your company is authorized to provide services.
  5. Services Authorized: Specify the types of services your company is authorized to offer, such as telecommunications or utility services.

Gathering this information ahead of time can streamline the filing process and help avoid any last-minute issues.

What happens if I miss the filing deadline for the Annual Report?

Missing the filing deadline for the Arizona Annual Report can lead to several consequences. Companies may incur late fees, and repeated failures to file can result in more severe penalties, including administrative dissolution or revocation of your business license. To avoid these issues, it’s wise to mark your calendar for the filing deadline and set reminders. If you do find yourself in a situation where you’ve missed the deadline, it’s important to file the report as soon as possible and reach out to the Arizona Corporation Commission for guidance on any penalties or next steps.

Common mistakes

Filling out the Arizona Annual Report form is a crucial task for businesses operating in the state. However, many individuals encounter common pitfalls that can lead to delays or complications. One frequent mistake is failing to update the company name or doing business as (dba) name. If the pre-printed name on the form is outdated, it is essential to correct it before submission. This simple step ensures that the report accurately reflects the current identity of the business.

Another common error is neglecting to provide a complete mailing address. The form requires a detailed street address, city, state, and zip code. Omitting any of these elements can result in miscommunication or lost correspondence. Additionally, including the correct telephone numbers—such as the main line, fax, and cell numbers—is vital. Failing to do so can hinder regulatory authorities from reaching out when necessary.

Management and regulatory contacts must be clearly identified, yet many people overlook this requirement. Providing the names, titles, and contact details for these individuals is important for establishing a point of contact for any inquiries. Inaccurate or incomplete information can lead to confusion and delays in processing the report.

Another mistake involves the statutory agent section. This part of the form requires the name and contact information of the statutory agent. Some individuals forget to fill this out or provide incorrect details, which can create legal complications. The statutory agent serves as the official point of contact for legal documents, so accuracy is key.

When indicating ownership structure, individuals often misclassify their business type. The form offers various options, including sole proprietor, partnership, and corporation, among others. Choosing the incorrect category can lead to compliance issues and may affect the company's legal standing.

Additionally, companies sometimes fail to check the appropriate boxes for the counties served. This oversight can result in the company being unable to provide services in certain areas, as regulatory compliance is closely tied to geographic certification. It is essential to ensure that all relevant counties are marked correctly.

Many businesses also overlook the section regarding services authorized to provide. This part of the form requires specific services to be checked off, such as telecommunications offerings. Neglecting to complete this section can lead to misunderstandings about what services the company is legally allowed to offer.

Statistical information is another area where mistakes frequently occur. Companies often provide inaccurate or incomplete data regarding their customer base and revenue. This information is critical for regulatory assessments, so ensuring its accuracy is paramount.

Lastly, individuals sometimes fail to check the box confirming that the company is current on payments for various regulatory assessments. This simple step is crucial for maintaining good standing with the Arizona Corporation Commission. Neglecting to confirm this can lead to additional scrutiny or penalties.

Documents used along the form

The Arizona Annual Report form is a vital document for businesses operating within the state. However, it is often accompanied by several other important forms and documents that help ensure compliance with state regulations and provide essential information about the company’s operations. Below are four such documents that are frequently used alongside the Arizona Annual Report form.

  • Articles of Incorporation: This document establishes a corporation in Arizona. It includes essential details such as the company’s name, purpose, and structure. Filing the Articles of Incorporation is typically one of the first steps in forming a business entity.
  • Operating Agreement: For Limited Liability Companies (LLCs), this internal document outlines the management structure and operating procedures. It defines the roles of members and managers, as well as how profits and losses will be distributed.
  • Bylaws: This document serves as the governing rules for a corporation. Bylaws detail the responsibilities of directors and officers, procedures for meetings, and voting rights. They help ensure that the corporation operates smoothly and in accordance with its stated goals.
  • Certificate of Good Standing: This certificate confirms that a business is legally registered and compliant with state regulations. It is often required for various business transactions, such as applying for loans or entering contracts.

Understanding these accompanying documents can greatly assist businesses in maintaining compliance and ensuring smooth operations. Each form plays a unique role in the overall structure and governance of a company, making them essential for any business owner in Arizona.

Similar forms

  • Annual Report for Corporations: Like the Arizona Annual Report, this document provides essential information about a corporation's financial health and operational status. It requires details such as the company name, address, and management information, ensuring that stakeholders have a clear understanding of the corporation's activities over the past year.
  • Business License Renewal Application: Similar to the Arizona Annual Report, this application is necessary for businesses to maintain their operational status. It typically asks for updated information about the business, including ownership details and compliance with local regulations, ensuring that the business remains in good standing with local authorities.
  • Tax Return Filing: Just as the Arizona Annual Report requires financial data, tax returns provide a comprehensive overview of a business’s income and expenses for the year. Both documents serve to inform regulatory bodies and ensure compliance with state laws, reflecting the financial activities of the entity.
  • Certificate of Good Standing: This document, like the Arizona Annual Report, verifies that a business is compliant with state regulations and has met all necessary filing requirements. It often includes similar information about the business's status and ownership, providing assurance to partners and customers alike.

Dos and Don'ts

When filling out the Arizona Annual Report form, it is important to follow certain guidelines to ensure that the process goes smoothly. Here are six things you should and shouldn't do:

  • Do verify that the company name is current and matches official records.
  • Do provide complete and accurate contact information for all relevant parties.
  • Do check all boxes that apply to your company, especially regarding ownership and services provided.
  • Do keep a copy of the completed form for your records.
  • Don't leave any sections blank unless instructed; incomplete forms may be returned.
  • Don't forget to review any changes in ownership or compliance issues before submission.

Misconceptions

  • Misconception 1: The Arizona Annual Report is optional for all businesses.
  • Many business owners believe that filing the Arizona Annual Report is not mandatory. However, it is a legal requirement for most corporations and limited liability companies operating in Arizona. Failing to file can result in penalties or even dissolution of the business.

  • Misconception 2: The report is only for large corporations.
  • Some assume that only large corporations need to file the report. In reality, all businesses, regardless of size, must submit the report if they are registered in Arizona. This includes sole proprietorships and small LLCs.

  • Misconception 3: The information required is minimal and straightforward.
  • While the report may seem simple, it requires detailed information about the company's ownership, management, and financial status. Incomplete or inaccurate submissions can lead to complications.

  • Misconception 4: Filing the report can be done at any time during the year.
  • There is a specific deadline for submitting the Arizona Annual Report. Typically, it must be filed by the end of the company's fiscal year. Missing this deadline can incur fines.

  • Misconception 5: The Annual Report is the same as tax filings.
  • Many people confuse the Annual Report with tax returns. While both documents require financial information, they serve different purposes and are submitted to different agencies.

  • Misconception 6: Only the owner needs to sign the report.
  • Some believe that only the business owner is required to sign the Annual Report. In fact, it often requires signatures from multiple officers or authorized individuals, depending on the company's structure.

  • Misconception 7: The report does not require updates for changes throughout the year.
  • Many business owners think they can submit the same information each year. However, any significant changes, such as ownership or contact information, must be updated in the report to ensure accuracy.

  • Misconception 8: The filing fee is negligible and not worth worrying about.
  • Some may underestimate the filing fee associated with the Annual Report. While it may seem small, it can add up, especially for businesses that fail to file on time and incur late fees.

  • Misconception 9: The Arizona Corporation Commission does not review the reports.
  • It is a common belief that the reports are simply collected without review. In reality, the Arizona Corporation Commission actively reviews submissions to ensure compliance with state regulations.

Key takeaways

Filling out the Arizona Annual Report form is an essential task for businesses operating in the state. Here are some key takeaways to ensure a smooth process:

  • Verify Company Name: Ensure the pre-printed company name is accurate. If not, make necessary changes directly on the form.
  • Complete Contact Information: Provide complete and current contact details, including mailing addresses, phone numbers, and email addresses.
  • Management and Regulatory Contacts: Clearly identify management and regulatory contacts, including their titles and contact information.
  • Ownership Information: Select the appropriate ownership type from the provided options, such as Sole Proprietor or Corporation.
  • Counties Served: Indicate all counties where your company is authorized to provide services. This is crucial for regulatory compliance.
  • Authorized Services: Mark all services your company is authorized to provide, ensuring you include any additional services not listed.
  • Statistical Data: Gather and report accurate statistical information, especially if your company is a telecommunications utility.
  • Compliance Notifications: If there have been any compliance issues or changes in ownership, document these in the designated sections of the form.

By following these guidelines, you can effectively complete the Arizona Annual Report and maintain compliance with state regulations.