2025 TELECOMMUNICATIONS PROVIDER SHORT FORM

Filing Deadline: March 1, 2025
Tax Division, Arkansas Public Service Commission
P.O. Box 8021 Little Rock, AR 72203
Phone: (501) 682-1231 Fax: (501) 682-6015
Email Address: tax@Arkansas.gov
Website: http://www.apscservices.info/tax
NP*field type single line
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Companyfield type single line
Input blocked. Maximum character limit of 4000 characters reached.
Addressfield type address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country
Contact Namefield type single line
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Telephone #field type single line
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Fax #field type single line
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Email Address*field type email
Ownded/Leased Property*field type checkbox
As of January 1, 2025, did the filing company own or lease real property in Arkansas?
Ownded/Leased PropertyYESNO
Contact our office immediately if you answered "YES" to the above question so that the necessary report forms can be sent to your company.
*field type checkbox
Is the company out of business?
YESNO
If the answer is "YES", please attach supporting documents.
*field type checkbox
Has the company ceased offering services in the state of Arkansas?
YESNO
If the answer is "YES", please attach supporting documents.
If respondent's Arkansas property is reported to the Tax Division by a parent company, please indicate the name and address of the parent company below:
Parent Companyfield type single line
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Parent Company Addressfield type address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country

Signature

Filer Namefield type single line
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Signaturefield type signature
Datefield type date
Attachmentsfield type file upload
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Is an Agent or 3rd party completing this form?field type checkbox
Is an Agent or 3rd party completing this form?YESNO
If yes, indicate your name and phone number.
Namefield type single line
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Telephone #field type number
Deadline March 1, 2025
A penalty of $100 per day may be levied from March 1 for delinquent reports.