INDIANA BUSINESS ENTITY REPORT
State Form 48725 (R6 / 8-14)
Approved by State Board of Accounts, 2014
INSTRUCTIONS:
Current entity name and principal office address (number and street, city, state, and ZIP code) Please make any changes to address here.
Business Corporation Professional Corporation Nonprofit Corporation Ag Coop Limited Liability Company
SECTION A
SECTION B
Current filing year Past filing years reported on this form
SECTION C
Date of incorporation / qualification / formation (month, day, year) State of domicile
SECTION D
(Please check the appropriate type for your corporate entity.)
SECTION E
P.O. box is not an acceptable address unless accompanied by a rural route number.
SECTION F
Current registered agent and registered address Please make changes to agent and address here.
Current President or highest officer and address (number and street, city, state, and ZIP code) Please make changes to officer and address here.
Please make changes to officer and address here.Current Secretary or other officer and address (number and street, city, state, and ZIP code)
1. All corporations must complete Sections A-H (Section G & H are located on the reverse side of this form).
2. All LLCs must complete Sections A-E and Section H.
3. File report online with a credit card. Refer to www.sos.in.gov.
4. Mail this completed report, along with a check or money order payable to Secretary of State, to Business Services at the above address.
Entity name can not be changed on this report.
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CONNIE LAWSON
SECRETARY OF STATE
BUSINESS SERVICES DIVISION
302 W. Washington Street, Room E018
Indianapolis, Indiana 46204
Telephone: (317) 232-6576
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All Indiana / domestic corporations must file a biennial report with the Secretary of State. The fee is $30.00 for a two-year
registration. The report is due in the anniversary month of incorporation. Corporations incorporated in an even year must file
every even year beginning in 1996. Corporations incorporated in an odd year must file every odd year beginning in 1997. For all
domestic corporations any reports due prior to 1996 were filed on an annual basis with a fee of $15.00 per year.
All foreign (non-Indiana) corporations must file a biennial report with the Secretary of State. The fee is $30.00 for a two-year
registration. The report is due in the anniversary month of qualification in Indiana. Corporations qualified in an odd year must file
every odd year beginning in 1997. Corporations qualified in an even year must file every even year beginning in 1998. For all
foreign corporations any reports due prior to 1997 were filed on an annual basis with a fee of $15.00.
All limited liability companies (LLC) must file a biennial report with the Secretary of State. The fee is $30.00 for a two-year
registration. The report is due in the anniversary month of organization or qualification in Indiana. LLCs organized in an odd year
must file every odd year beginning in 1997. LLCs qualified in an even year must file every even year beginning in 1998. For all
LLCs any reports due prior to 1997 were filed on an annual basis with a fee of $15.00.
All nonprofit corporations (domestic and foreign) must file annual reports in the anniversary month of incorporation. The filing fee
is $10.00 per year.
These entities do not file corporate reports.
ZIP CodeStateCityStreet Address (number and street)Name of Director
SECTION G
(Please list the name(s) and address(es) of current director(s). If necessary, attach an additional sheet.)
FEE SCHEDULE
DOMESTIC CORPORATIONS
FOREIGN CORPORATIONS
LIMITED LIABILITY COMPANIES (domestic and foreign)
NONPROFIT CORPORATIONS
LIMITED LIABILITY PARTNERSHIPS AND LIMITED PARTNERSHIPS
SECTION H
(This must be signed by a corporate officer, chairman of the board, registered agent, certified public accountant or
an attorney employed by the entity or by a member of manager of the LLC.)
This document is signed under the penalties of perjury. (Check the fee schedule below.)
Signature Date of signature (month, day, year)
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Required if registered agent information was updated:
By checking the box, the signator(s) represent(s) that the registered agent named in the application has consented to
the appointment of the registered agent.
