CFCVLR REV 03/2020
Arizona Corporation Commission – Corporations Division
Page 1 of 1
DO NOT WRITE ABOVE THIS LINE; RESERVED FOR ACC USE ONLY.
WHAT ARE YOU FILING?
Pick up
Name:
Mail
Name:
Address:
PAYMENT:
MOD Account #:
FOR ARIZONA CORPORATION COMMISSION USE ONLY
PICK-UP BY: _________________________________________________ DATE: ________________
View current processing times at:
http://azcc.gov/docs/default-source/corps-files/document-processing-times.pdf
Email
Phone number REQUIRED:
City:
State:
Zip:
YES - select 1 option below
NO - pay only the filing fee
New Entity Change to existing entity Re-submission of rejected filing
EXPEDITED PROCESSING?
ENTITY NAME - give the exact name of the entity as currently shown in A.C.C. records:
DOCUMENTS WILL BE MAILED IF THEY ARE NOT PICKED UP IN A TIMELY MANNER (APPROXIMATELY ONE WEEK)
Cash - do not mail cash. We do not accept bills over $20.00.
Cash may be used only for in-person submittals at the Phoenix office ONLY (Tucson does not accept cash).
Checks or money orders - must be made payable to "Arizona Corporation Commission," with all words spelled out and no
abbreviations. Checks must be completely and properly filled out, including the amount sections. UNACCEPTABLE CHECKS include: no imprinted
or preprinted name and address of the account holder; no imprinted or preprinted check number; handwritten or stamped names, addresses, or
check numbers; temporary checks (new accounts).
Credit cards - may be used for in-person submittals, and for online corporation annual reports, online name reservations, or online certificates
of good standing. We accept only Visa or MasterCard.
NOTE: A current phone number is required for ALL Same Day/Next Day services. Same Day/Next Day service will not guarantee approval of
submitted document(s) and only guarantees that the document(s) will be examined within the stated time frames. All fees are nonrefundable.
Document filing fees are listed on the bottom of each form or on the fee schedule on our website, http://ecorp.azcc.gov, under the FAQs.
Total amount to deduct:
REQUIRED - RETURN DELIVERY OPTION (PLEASE PRINT CLEARLY and select only ONE):
NOTE: PHONE NUMBER REQUIRED FOR ALL RETURN DELIVERY OPTIONS
Email address REQUIRED:
Phone number REQUIRED:
Phone number REQUIRED:
EXPEDITED PROCESSING, ADD $35.00
TWO-HOUR SERVICE, ADD $400.00
Document will be examined within 2-hours of submission
Must be received by 3:00pm MST
SAME DAY SERVICE, ADD $200.00
Document will be examined by 5:00pm MST and must
be received by 10:00am MST
NEXT DAY SERVICE, ADD $100.00
Document will be examined by 5:00pm MST on the
next business day. Must be received by 5:00pm MST
ARIZONA CORPORATION COMMISSION CORPORATIONS DIVISION
COVER SHEET
USE A SEPARATE COVER SHEET FOR EACH DOCUMENT
** ORDER COPIES USING A RECORDS REQUEST FORM **
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