"Entrepreneur Fee Waiver Pilot Program Application Form" - Arkansas

Entrepreneur Fee Waiver Pilot Program Application Form is a legal document that was released by the Arkansas Development Finance Authority - a government authority operating within Arkansas.

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Entrepreneur Fee Waiver Pilot Program

Application

Eligibility

To qualify for a waiver of your Arkansas state filing fees according to Act 857 of 2017, you must:

•

Be a permanent resident of the state of Arkansas who possesses a driver’s license

PLUS one of the following – birth certificate, passport, green card, or tribal card.

•

Be starting a business that has not previously existed in the state of Arkansas.

•

Ensure that your business is eligible by checking to see that it is not on the “ineligible

businesses” list derived from the federal Small Business Administration (see page

2-3).

•

Agree to provide follow-up data (as described in Act 857 of 2017 and on page 6 of this

application) in order to allow program administrators to evaluate the success of the

Entrepreneur Fee Waiver Pilot Program.

•

Meet the Secretary of State’s eligibility requirements.

Instructions

1. Complete pp. 4-6 of this form as indicated by typing in responses. Print, then sign and

date and initial by hand in ink. Incomplete applications will not be considered.

2. Go to the Arkansas Secretary of State’s Business and Commercial Services Website to

find the form for submission of your filing fee:

https://www.sos.arkansas.gov/

business-commercial-services-bcs/forms-fees

3. Select the type of company you plan to form and then click on the PDF version of the

form (e.g., Articles of Organization for an LLC). Fill out the form, but instead of

consulting the fee schedules to determine your fee payment, submit the filing form

along with the EFWPP application (items #1 and #2 in this list) to request your fee

waiver.

4. Mail both of the documents (Secretary of State’s filing form and EFWPP application) to:

ATTN: EFWPP

Arkansas Secretary of State

Business and Commercial Services

1401 W. Capitol, Suite 250 Little

Rock, AR 72201

ADVISORY: If your new corporation is found at any time to be ineligible according to these eligibility

conditions, even after a fee waiver and incorporation, the corporation will be dissolved as the registration

will be deemed invalid and void. The owner or founder will have to start over, reapply for corporate status

and pay the filing fee, with no guarantee of approval.

Entrepreneur Fee Waiver Pilot Program

Application

Eligibility

To qualify for a waiver of your Arkansas state filing fees according to Act 857 of 2017, you must:

•

Be a permanent resident of the state of Arkansas who possesses a driver’s license

PLUS one of the following – birth certificate, passport, green card, or tribal card.

•

Be starting a business that has not previously existed in the state of Arkansas.

•

Ensure that your business is eligible by checking to see that it is not on the “ineligible

businesses” list derived from the federal Small Business Administration (see page

2-3).

•

Agree to provide follow-up data (as described in Act 857 of 2017 and on page 6 of this

application) in order to allow program administrators to evaluate the success of the

Entrepreneur Fee Waiver Pilot Program.

•

Meet the Secretary of State’s eligibility requirements.

Instructions

1. Complete pp. 4-6 of this form as indicated by typing in responses. Print, then sign and

date and initial by hand in ink. Incomplete applications will not be considered.

2. Go to the Arkansas Secretary of State’s Business and Commercial Services Website to

find the form for submission of your filing fee:

https://www.sos.arkansas.gov/

business-commercial-services-bcs/forms-fees

3. Select the type of company you plan to form and then click on the PDF version of the

form (e.g., Articles of Organization for an LLC). Fill out the form, but instead of

consulting the fee schedules to determine your fee payment, submit the filing form

along with the EFWPP application (items #1 and #2 in this list) to request your fee

waiver.

4. Mail both of the documents (Secretary of State’s filing form and EFWPP application) to:

ATTN: EFWPP

Arkansas Secretary of State

Business and Commercial Services

1401 W. Capitol, Suite 250 Little

Rock, AR 72201

ADVISORY: If your new corporation is found at any time to be ineligible according to these eligibility

conditions, even after a fee waiver and incorporation, the corporation will be dissolved as the registration

will be deemed invalid and void. The owner or founder will have to start over, reapply for corporate status

and pay the filing fee, with no guarantee of approval.

EFWPP Application

Eligibility Restrictions

Please note that certain types of businesses are not eligible for the EFWPP. The categories for those

ineligible businesses are aligned with the federal list of ineligible businesses in 13 CFR 120.110.

The following types of businesses are NOT eligible:

(a) Non-profit businesses (for-profit subsidiaries are eligible);

(b) Financial businesses primarily engaged in the business of lending, such as banks, finance companies,

and factors (pawn shops, although engaged in lending, may qualify in some circumstances);

acquired or improved with the loan proceeds (except Eligible Passive Companies under § 120.111);

(d) Life insurance companies;

(e) Businesses located in a foreign country (businesses in the U.S. owned by aliens may qualify);

(f) Pyramid sale distribution plans;

(g) Businesses deriving more than one-third of gross annual revenue from legal gambling activities;

(h) Businesses engaged in any illegal activity;

(i) Private clubs and businesses which limit the number of memberships for reasons other than capacity;

(j) Government-owned entities (except for businesses owned or controlled by a Native American tribe);

(k) Businesses principally engaged in teaching, instructing, counseling or indoctrinating religion or

religious beliefs, whether in a religious or secular setting;

(l) [Reserved]

(m) Loan packagers earning more than one third of their gross annual revenue from

packaging SBA loans;

(n) Businesses with an Associate who is incarcerated, on probation, on parole, or has been indicted for a

felony or a crime of moral turpitude;

(o) Businesses in which the Lender or CDC, or any of its Associates owns an equity interest;

(p) Businesses which:

(1) Present live performances of a prurient sexual nature; or

(2) Derive directly or indirectly more than de minimis gross revenue through the sale of products

or services, or the presentation of any depictions or displays, of a prurient sexual nature;

EFWPP Application

(q) Unless waived by SBA for good cause, businesses that have previously defaulted on a Federal loan or

Federally assisted financing, resulting in the Federal government or any of its agencies or Departments

sustaining a loss in any of its programs, and businesses owned or controlled by an applicant or any of

its Associates which previously owned, operated, or controlled a business which defaulted on a Federal

loan (or guaranteed a loan which was defaulted) and caused the Federal government or any of its agencies

or Departments to sustain a loss in any of its programs. For purposes of this section, a

compromise agreement shall also be considered a loss;

(r) Businesses primarily engaged in political or lobbying activities; and

(s) Speculative businesses (such as oil wildcatting).

[ 61 FR 3235, Jan. 31, 1996, as amended at 82 FR 39502, Aug. 21, 2017]

The Arkansas Development Finance Authority supplies applications for the Entrepreneur Fee Waiver

Pilot Program created under Act 857 of 2017 at the request of the Arkansas General Assembly.

EFWPP Application

FILLABLE FORM: Please TYPE responses, PRINT form, and SIGN by hand in ink.

Clear Form

GENERAL INFORMATION

1. Legal name of applicant:__________________________________________________________

2. SSN or Fed. Tax ID: _____________________________________________________________

3. Planned Business Name:__________________________________________________________

4. Planned type of company:

Sub-S ☐

C-Corp ☐

LLC ☐

Other: ________________________________________

5. Mailing address of applicant: ______________________________________________________

City:_____________________________ State: _____________________ Zip: ______________

6. Email address:__________________________________________________________________

7. Website address: ________________________________________________________________

8. Primary phone: ________________________________________

9. Other phone: __________________________________________

10. Fax: _________________________________________________

11. Attorney/Accountant contact information (if applicable):

Name: ________________________________________________________________________

Mailing address: ________________________________________________________________

Phone number: ________________________________________

Email address: ________________________________________

II. PARTNERSHIPS

Additional partners or owners:

1. Legal name of partner: ___________________________________________________________

2. SSN or Fed. Tax ID: _____________________________________________________________

3. Mailing address of partner: ______________________________________________________

City:_____________________________ State: _____________________ Zip: ______________

4. Email address:__________________________________________________________________

5. Website address: ________________________________________________________________

6. Primary phone: ________________________________________

7. Other phone: __________________________________________

8. Fax: _________________________________________________

(For additional partners please attach an additional sheet giving this contact information for each

partner. All owners and partners must be listed.)

III. NAICS CODE

The State of Arkansas uses the North American Industry Classification System (NAICS) to identify a

firm’s area of specialty or expertise. Please indicate below the NAICS code(s) for the business you plan to

operate. NAICS codes may be found here:

https://www.naics.com/search/

NAICS Code

Description of Work/Service

__________

________________________________________________________________________

__________

________________________________________________________________________

EFWPP Application

IV. DESCRIPTION OF PLANNED BUSINESS

Please describe in approximately 50-100 words your planned business including the type of products or

services you will offer, where you will locate your business, and your target customers and sales channels

or method of delivery.

List any related business entities:

V. SIGNATURE (Note that signature, initials, and date below must be signed in ink after printout.)

I certify that I am a permanent resident of the state of Arkansas who possesses the following forms of

identification should verification be required: driver’s license PLUS one of the following – birth

certificate, passport, green card, or tribal card. _______ (initial)

I certify that I have not previously formed this business under any other name in Arkansas. _____ (initial)

I certify that this business is not a type of business listed as an “ineligible business” on pp. 2-3 of this

application. ______ (initial)

I certify that this business is intended to create jobs in the state of Arkansas as follows: (list number of

jobs and field, i.e. 5 sales reps, 1 manager, 10 pest control technicians):

I swear and affirm under penalty of law that the

information submitted in this application is accurate.

__________________________________________

Signature

___________________________________________

Date

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