Prepayment Account Deposit Form
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Prepayment Account Deposit Form. This is a Ohio form and can be use in General Secretary Of State.
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Tags: Prepayment Account Deposit Form, Ohio Secretary Of State, General
OHIO SECRETARY OF STATE
BUSINESS SERVICES DIVISION
PREPAYMENT ACCOUNT DEPOSIT FORM
Business Name
Business Address
City
State
Zip Code
Primary Contact:
Secondary Contact:
Name
Name
(Area Code) Phone #
(Area Code) Phone #
Email Address
Email Address
The following Prepayment Account # has been established with the Secretary of State’s Office for the exclusive use of the
above named business. Unauthorized use may result in cancellation of the filings processed.
Secretary of State: Please process the check(s) or cash amount submitted with this form, and deposit
the amount to the Prepayment Account # listed below.
Prepayment Account:
/
/
/
/
/
/
/
/
/
Confidential
Amount submitted for deposit:
$
TYPE OF PAYMENT:
Cash Receipt #
Check #
Note: Businesses may elect to use their logo and address information in customizing this form for their use.
Reconcilement of Account activity is the responsibility of the business establishing the account. Account
information may be monitored via the internet at: www.state.oh.us/sos/. SOS should be notified of
discrepancies within 45 days of posting. Correspondence concerning Prepayment Accounts can be
emailed to: prepay@sos.state.oh.us
SOS Office Use Only:
Processed by:
Batch#/Order#:
Date:
Last Updated: December 12, 2001
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