ANNUAL REPORT / ANNUAL FEES(PLEASE TYPE OR PRINT CLEARLY IN INK)The following is a list of Cooperatives and Associations which are required under Arkansas law to file an annual report and if applicable, pay a fee to the office of the Secretary of State. Please complete the information and return the report and the required fee for your organization. Name of Cooperative or Association: Address: Contact Person: Phone Number: E-mail Address: PLEASE CHECK ONE OF THE FOLLOWING Agricultural Cooperative AssociationC.A. 2-2-123ANNUAL FEE - $10.00Electrical Cooperatives DUE BEFORE July 1 OF EACH YEARC.A. 23-18-329ANNUAL FEE - $10.00 per 100 members or fractional thereofNumber of members: Fee:Marketing Association (PLEASE SUBMIT THESE REQUIREMENTS BY ATTACHMENT.)C.A. 2-2-422 Annual Report NO FEEPrincipal place of business:Provide a general statement of the business operations during the fiscal year showing:The amount of capital stock paid up and the number of stockholders of the stock association; or the number ofmembers and amount of membership fees received if a non-stock association;The total expense of operations;The amount of indebtedness or liability; andA balance sheet Cooperation AssociationC.A. 4-30-114 Annual Report NO FEEName ofStockholders and amount of stock owned by each: Attach separate list if necessary Other Association Type and Authority: CRD-01 Rev. 001027021n024030n030007r013027r031n027035025016007031n031r American LegalNet, Inc. www.FormsWorkFlow.com