The Arizona Annual Report form, required by the Arizona Corporation Commission Utilities Division, is a vital document for companies to update their official information yearly. This report includes company details, management information, important changes during the year, ownership, counties served, services provided, and statistical information. To ensure your business complies with Arizona state regulations, make sure to fill out and submit this form accurately. Click the button below to start filling out your Arizona Annual Report form.
Filing an Arizona Annual Report is a critical task for businesses operating within the state, ensuring they remain in good standing with the Arizona Corporation Commission's Utilities Division. This comprehensive form serves multiple purposes, which include updating the commission on any changes to the company's contact information, management structure, ownership, and service areas. It's designed to provide a snapshot of the company's operational status as of December 31st of the reported year. Entities are required to disclose their current mailing and local office addresses, contact numbers, and email addresses, along with detailed information about management and regulatory contacts. Additionally, the report seeks insights into any significant changes during the year, such as shifts in ownership, compliance issues notified by other regulatory bodies, and the geographical scope of their service provision. Companies must also specify the type of services they are authorized to offer, ranging from telecommunications to specialized services, and submit statistical data related to their operations, customer base, and financial health. Notably, the form accommodates a variety of business structures, from sole proprietorships to limited liability companies, indicating a tailored approach to gathering relevant data from a diverse business ecosystem. The obligation to file this report underlines the importance of transparency and regulatory compliance, essential for maintaining the integrity of Arizona's business landscape.
ARIZONA CORPORATION COMMISSION
UTILITIES DIVISION
ANNUAL REPORT MAILING LABEL – MAKE CHANGES AS NECESSARY
Please click here if pre-printed Company name on this form is not your current Company name or dba name is not included.
Please list current Company name including dba here:
__________________________________________________________________________
ANNUAL REPORT
FOR YEAR ENDING
12
31
2020
FOR COMMISSION USE
ANN 03
20
COMPANY INFORMATION
Company Name (Business Name) _________________________________________________________
Mailing Address ____________________________________________________________________________
(Street)
_________________________________________________________________________________________
(City)(State)(Zip)
__________________________________________________________________________________________
Telephone No. (Include Area Code)Fax No. (Include Area Code)Cell No. (Include Area Code)
Email Address______________________________________________________________________________
Local Office Mailing Address _______________________________________________________________
__________________________________________________________1-800-___________________________
Customer Service Phone No. (Include Area Code)
Website address ___________________________________________________________________________
MANAGEMENT INFORMATION
Management Contact:_________________________________________________________________________________
(Name)(Title)
_______________________________________________________________________________________________________________________
(City)
(State)
(Zip)
Telephone No. (Include Area Code)
Fax No. (Include Area Code)
Cell No. (Include Area Code)
Regulatory Contact:___________________________________________________________________
(Name)
2
Statutory Agent:__________________________________________________________________________
________________________________________________________________________________________________________________________
(Street)(City)(State)(Zip)
____________________________________________________________________________________________________________
Telephone No. (Include Area Code)Fax No. (Include Area CodeCell No. (Include Area Code)
Attorney:________________________________________________________________________________
Email Address:_____________________________________________________________________________
Important Changes During the Year
Yes __ No __
For those companies not subject to the affiliated interest rules, has there been a change in ownership or direct control during the year?
If yes, please provide specific details in the box below.
Has the company been notified by any other regulatory authorities during the year that they are out of compliance?
3
OWNERSHIP INFORMATION
Check the following box that applies to your company:
Sole Proprietor (S)
Partnership (P)
Bankruptcy (B)
Receivership (R)
CCorporation (C) (Other than Association/Co-op) Subchapter S Corporation (Z)
Association/Co-op (A) Limited Liability Company
Other (Describe)______________________________________________________________________
COUNTIES SERVED
Check the box below for the counties in which you are certificated to provide service:
STATEWIDE
APACHE
GILA
LA PAZ
NAVAJO
SANTA CRUZ
COCHISE
GRAHAM
MARICOPA
PIMA
YAVAPAI
COCONINO
GREENLEE
MOHAVE
PINAL
YUMA
4
SERVICES AUTHORIZED TO PROVIDE
Check the following box(es) for the services that you are authorized to provide:
Resold Long Distance/Interexchange Telecommunications Services (RLD) Resold Local Exchange Telecommunications Services (RLEC)
Facilities-Based Long Distance/Interexchange Telecommunications Services (IXC) Facilities Based Local Exchange Telecommunications Services (CLEC)
Facilities Based Private Line Telecommunications Services Alternative Operator Service Provider
Other (Specify)______________________________________________________________________
STATISTICAL INFORMATION
TELECOMMUNICATION UTILITIES ONLY
Total number of residential local exchange access lines
Total number of residential local exchange customers
Total number of business local exchange access lines
Total number of business local exchange customers
Total quantity of phone numbers assigned to Company
Total phone numbers assigned to Customers by Company
Total number of long distance residential customers
Total number of long distance business customers
Total intrastate local exchange revenue from Arizona operations
Total intrastate long distance/interexchange revenue from Arizona operations Total intrastate revenue from Arizona operations
Total intrastate income from Arizona operations
Value of Company’s total assets in Arizona Value of Company’s total assets
(Value of Company’s total assets in Arizona)/(Value of company’s total assets)
Current amount of deposits, prepayments, and advances from customers
(not including monthly service bills)
Current amount of performance bond
Current amount of Irrevocable Sight Draft Letter of Credit
Check box if Company is current on payments for:
Regulatory Assessment
AZ Universal Service Fund
AZ 911/E911
Circuit
Voice over Internet
Switched
Protocol (“VoIP”)
_______________
________________
__________________________________
RetailOther
_______________ ________________
$_________________________________
%_________________________________
AZ Telephone Relay Service
5
UTILITY SHUTOFFS/DISCONNECTS
MONTH
Termination without Notice
R14-2-509.B
Termination with Notice
R14-2-509.C
OTHER
TOTALS →
OTHER (description):
6
VERIFICATION
AND
SWORN STATEMENT
STATE OF ________________
I, THE UNDERSIGNED OF THE
Intrastate Revenues Only
COUNTY OF (COUNTY NAME)
NAME (OWNER OR OFFICIAL) TITLE
COMPANY NAME
DO SAY THAT THIS ANNUAL UTILITY REPORT TO THE ARIZONA CORPORATION COMMISSION
FOR THE YEAR ENDING
DAY
YEAR
HAS BEEN PREPARED UNDER MY DIRECTION, FROM THE ORIGINAL BOOKS, PAPERS AND RECORDS OF SAID UTILITY; THAT I HAVE CAREFULLY EXAMINED THE SAME, AND DECLARE THE SAME TO BE A COMPLETE AND CORRECT STATEMENT OF BUSINESS AND AFFAIRS OF SAID UTILITY FOR THE PERIOD COVERED BY THIS REPORT IN RESPECT TO EACH AND EVERY MATTER AND THING SET FORTH, TO THE BEST OF MY KNOWLEDGE, INFORMATION AND BELIEF.
IN ACCORDANCE WITH THE REQUIREMENT OF TITLE 40, ARTICLE 8, SECTION 40- 401, ARIZONA REVISED STATUTES, IT IS HEREIN REPORTED THAT THE GROSS OPERATING REVENUE OF SAID UTILITY DERIVED FROM ARIZONA INTRASTATE UTILITY OPERATIONS DURING CALENDAR YEAR 2020 WAS:
Arizona Intrastate Gross Operating Revenues Only ($)
$___________________________
(THE AMOUNT IN BOX ABOVE
INCLUDES $_________________
IN SALES TAXES BILLED, OR COLLECTED)
**REVENUE REPORTED ON THIS PAGE MUST INCLUDE SALES TAXES BILLED OR COLLECTED. IF FOR ANY OTHER REASON, THE REVENUE REPORTED ABOVE DOES NOT AGREE WITH TOTAL OPERATING REVENUES ELSEWHERE REPORTED, ATTACH THOSE STATEMENTS THAT RECONCILE THE DIFFERENCE. (EXPLAIN IN DETAIL)
SIGNATURE OF OWNER OR OFFICIAL
TELEPHONE NUMBER
SUBSCRIBED AND SWORN TO BEFORE ME
A NOTARY PUBLIC IN AND FOR THE COUNTY OF
THIS
DAY OF
(SEAL)
MY COMMISSION EXPIRES____________________________
COUNTY NAME
20__
SIGNATURE OF NOTARY PUBLIC
7
RESIDENTIAL REVENUE
STATE OF ARIZONA
I, THE UNDERSIGNED
OF THE
INTRASTATE REVENUES ONLY
NAME (OWNER OR OFFICIAL)
TITLE
MONTH DAY YEAR
12 31 2020
IN ACCORDANCE WITH THE REQUIREMENTS OF TITLE 40, ARTICLE 8, SECTION 40- 401.01, ARIZONA REVISED STATUTES, IT IS HEREIN REPORTED THAT THE GROSS OPERATING REVENUE OF SAID UTILITY DERIVED FROM ARIZONA INTRASTATE UTILITY OPERATIONS RECEIVED FROM RESIDENTIAL CUSTOMERS DURING CALENDAR YEAR 2020 WAS:
ARIZONA INTRASTATE GROSS OPERATING REVENUES
$_________________________
(THE AMOUNT IN BOX AT LEFT INCLUDES $_____________________________
*RESIDENTIAL REVENUE REPORTED ON THIS PAGE MUST INCLUDE SALES TAXES BILLED.
MY COMMISSION EXPIRES
NOTARY PUBLIC NAME
8
FINANCIAL INFORMATION
Income Statements:
Attach to this annual report a copy of the company’s year-end (Calendar Year 2020) financial statements.
Alternative templates are provided for this information. Please select one from Figure 1A, Figure 1B or Figure 1C.
(All Facilities-Based CLECs, Facilities-Based IXCs, Facilities-Based Access Line Providers & Facilities-Based Private Line Providers must submit FIGURE 1C)
Arizona Administrative Code, R14.2.1115.F, states that one of the items required in this Annual Report is a statement of income for the reporting year
Balance Sheets:
Alternative templates are provided for this information. Please select one from Figure 2A or Figure 2B.
(All Facilities-Based CLECs, Facilities-Based IXCs, Facilities-Based Access Line Providers & Facilities-Based Private Line Providers must submit FIGURE 2B)
Arizona Administrative Code, R14.2.1115.F, states that one of the items required in this Annual Report is a balance sheet as of the end of the reporting year
ALL INFORMATION MUST BE ARIZONA-SPECIFIC AND REFLECT OPERATING
RESULTS IN ARIZONA.
9
Docket No. _____________________Year Ending: 12-31-20
Company Name: ___________________________________________________
FIGURE 1A
Account Description
$ Amount
Revenues:
Expenses:
Operating Income:
Net Income:
Attachment 1
10
Filling out the Arizona Annual Report form is a vital step for businesses to ensure compliance with state regulations. This process can initially seem daunting, but breaking it down into manageable steps makes it far more approachable. This guide provides an easy-to-follow pathway for completing the form accurately and efficiently, ensuring that your business remains in good standing.
Once all sections of the form have been accurately completed, review the information for accuracy. It's important to double-check every entry to prevent any errors that could delay processing. After ensuring all the information is correct and complete, submit the form following the instructions provided by the Arizona Corporation Commission Utilities Division. This step is crucial for maintaining your business’s compliance and good standing within the state.
What is the purpose of the Arizona Annual Report form?
The Arizona Annual Report form is a required document that regulated utility companies must submit to the Arizona Corporation Commission Utilities Division. It gathers comprehensive information about the company's operations, management, and financial status over the past year. This report aids in the regulatory oversight and ensures companies comply with Arizona's regulations.
Who needs to file the Arizona Annual Report?
All regulated utility companies operating within the state of Arizona are required to file this annual report. This includes companies providing telecommunications, electricity, water, and other utility services under the jurisdiction of the Arizona Corporation Commission.
How can a company make changes to the pre-printed company name on the form?
If the pre-printed company name or dba (doing business as) name on the form is incorrect, companies can make changes by clearly listing the current company name, including any dba name, in the space provided at the beginning of the form.
What management information must be provided in the report?
The report requires detailed information about the company’s management, including the management contact, regulatory contact, statutory agent, and attorney. For each, the full name, mailing address, phone numbers, and email address must be provided. This information helps the Commission communicate effectively with the company’s representatives.
What happens if there have been important changes during the year?
Companies must disclose any significant changes during the reporting year, such as changes in ownership, direct control, or notifications of non-compliance from other regulatory authorities. Specific details of these changes must be included in the report to keep the Commission informed about the company's current status and compliance.
How should a company report its ownership structure in the report?
The form includes a section for companies to check the box that best describes their ownership structure, such as Sole Proprietor, Partnership, C Corporation, Subchapter S Corporation, Limited Liability Company, etc. If the structure is 'Other,' a detailed description must be provided. This information helps in understanding the company’s governance and financial foundation.
What counties served should be reported?
Companies must check the boxes for all counties in Arizona where they are certified to provide service. This helps the Commission track the geographic coverage and service availability across the state.
What types of services authorized to provide should be included in the report?
The report requires companies to indicate the types of services they are authorized to provide, such as telecommunication services, by checking the appropriate boxes. This includes both resold and facilities-based services, among others. Companies must also specify any other services they offer that are not listed on the form.
What financial and statistical information must be included in the report?
Companies must provide detailed financial and statistical information, including the number of customers, revenue from operations in Arizona, total assets in Arizona, and current amounts of deposits and other financial assurances. This comprehensive financial data helps the Commission assess the company's economic health and regulatory compliance.
Filling out the Arizona Annual Report form is a crucial aspect of maintaining compliance with the state's reporting requirements for businesses. However, it's fraught with potential pitfalls. A common mistake is neglecting to update the company name and doing business as (DBA) name. It's vital to ensure that any change in these areas is reflected in the report, as using outdated or incorrect information can lead to processing delays or misunderstandings about the entity’s legal status.
Another oversight occurs with the mailing address and contact information sections. Accuracy here is paramount. Incorrect or outdated mailing addresses, phone numbers, and email addresses can impede communication between the Arizona Corporation Commission and the business, potentially leading to missed notices or deadlines. A related error is not accurately updating the local office mailing address and customer service phone numbers, which can confuse or frustrate customers seeking assistance.
Management and regulatory contact information is often skimmed over or filled out haphazardly. It is essential to provide updated and precise contact details for those in management and regulatory positions. Failure to do so could result in critical information not reaching the right individuals, which in turn could affect the company's operational compliance.
When it comes to reporting significant changes during the year, such as changes in ownership or compliance issues, some entities mistakenly check 'No' due to a misunderstanding of what constitutes a significant change. This oversight can have serious implications, particularly if the business undergoes scrutiny or an audit.
The section on ownership structure is also a common area for mistakes. Businesses sometimes tick the wrong box for their company type or leave this section blank. Proper classification is crucial for legal and tax purposes, impacting how the Commission views and interacts with the entity.
Not specifying the correct counties served or services authorized to provide is another error. This not only affects regulatory records but can also limit the company's operational scope within the state. Oversight here might restrict a company’s ability to expand or adjust its offerings in the future.
In the statistical information section, inaccuracies or estimations rather than precise figures can lead to a misrepresentation of the company's scale and operations. This information is critical for regulatory assessments and ensuring that businesses contribute appropriately to state funds like the AZ Universal Service Fund and 911/E911 services.
Failing to verify the current status of regulatory payments—including those for the AZ Universal Service Fund and AZ Telephone Relay Service—can reflect poorly on the business. It’s a mistake to overlook checking these boxes if the company is current on its payments, as it might suggest negligence in maintaining financial obligations to state-regulated funds.
All these points underscore a broader theme: thoroughness and accuracy are paramount when completing the Arizona Annual Report. Businesses must approach this task diligently, understanding that the document serves as a critical interface between their operations and regulatory authorities.
In the process of fulfilling the obligations and maintaining compliance with the Arizona Corporation Commission Utilities Division, entities may have to prepare and submit various forms and documents alongside the Arizona Annual Report. These documents each have their function and importance in ensuring that the company meets the legal requirements for operation within the state. A list of commonly used documents includes:
Together, these documents support a company's legal foundation, operational clarity, and compliance with state regulations. Each plays a pivotal role in different aspects of the business's lifecycle, from formation to operational compliance, and helps in safeguarding the business's legal interests within Arizona. Keeping these documents updated and in compliance with state laws is essential for the smooth operation and legal integrity of any business.
The Arizona Annual Report form bears resemblance to the Internal Revenue Service (IRS) Form 1120, which is used by U.S. corporations to file their annual income taxes. Much like the Arizona form, the IRS document collects detailed information about the company's financial activities throughout the fiscal year. Both forms require data on the company's earnings, assets, and administrative contact information, facilitating regulatory compliance and financial transparency to the relevant authorities.
Similarly, the form mirrors the elements found in the Secretary of State's Annual Registration for businesses. This registration typically mandates updated contact information, details about company management, and changes in the business structure. Both documents serve to keep public records current, helping in the administration of corporate governance and ensuring that entities are legally compliant in their operations within the respective states.
Another comparable document includes the Uniform Business Report (UBR), utilized by various states to consolidate business reporting requirements. Like the Arizona Annual Report, the UBR collects comprehensive data on company management, ownership structure, and operational details. These forms are instrumental in streamlining the reporting process across different jurisdictions, making it easier for businesses to adhere to regulatory requirements uniformly.
Lastly, the Arizona Annual Report can be likened to the Occupational Safety and Health Administration (OSHA) Form 300A, which summarizes job-related injuries and illnesses logged throughout the year. Although focusing on workplace safety rather than corporate governance or financial status, both documents are compulsory annual submissions that record specific aspects of a company's yearly operations. They contribute to the oversight and improvement of important organizational measures – financial transparency, in the case of the Arizona form, and workplace safety, in OSHA’s case.
When filling out the Arizona Annual Report form, there are several important dos and don'ts to keep in mind to ensure the process goes smoothly and accurately. Here is a list of seven key points to consider:
By carefully following these guidelines, you can complete the Arizona Annual Report form effectively and accurately, helping to ensure your company remains compliant and in good standing with the Arizona Corporation Commission.
Understanding the Arizona Annual Report form is crucial for any business operating within the state. However, there are several misconceptions that can create confusion. Here are seven common misunderstandings explained clearly:
Correcting these misconceptions helps ensure that businesses comply properly with Arizona's regulations, maintaining good standing and avoiding unnecessary penalties.
Filing the Arizona Annual Report requires attention to detail and is crucial for maintaining compliance with the Arizona Corporation Commission. The form encompasses various sections, each with its specific requirements. To facilitate this process, here are five key takeaways:
Lastly, review the form carefully before submission to ensure accuracy and completeness. The Arizona Annual Report is a key document that reflects your company's current status and operational scope within the state, making its accurate completion a priority.
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