NEVADA ANNUAL STATEMENT
PUBLICATION FORM
Use this form if paying by credit or debit card.

      2025 Annual Statement of ... ( enter name of Company here )


      Company Officer Name & Title   (ONE title only)


      Company Principal Address


      Company Principal Address City/State/Zip


      NV Registered Agent Address


      NV Registered Agent City/State/Zip



      Upon publication a Certification of Publication will be sent to you by first class mail.

      Please tell us where to send the Certification.

      Contact Name


      Contact Company Name


      Contact Address


      Contact City/State/Zip

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