Form T100 "Application for a State Cable & Video Franchise" - Louisiana

What Is Form T100?

This is a legal form that was released by the Louisiana Secretary of State - a government authority operating within Louisiana. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 1, 2018;
  • The latest edition provided by the Louisiana Secretary of State;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form T100 by clicking the link below or browse more documents and templates provided by the Louisiana Secretary of State.

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Download Form T100 "Application for a State Cable & Video Franchise" - Louisiana

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S
L
Commercial Division
TATE OF
OUISIANA
(225) 925-4704
S
S
ECRETARY OF
TATE
R. Kyle Ardoin
Fax Numbers
SECRETARY OF STATE
(225) 932-5314 Corporations
(225) 932-5317 Legal Services
(225) 932-5318 UCC
TRANSMITTAL INFORMATION
For All Business Filings
Please indicate below the level of service requested, payment and contact information
Routine
Expedite $30
Priority Expedite $50
24 hour processing
2-4 hour processing
Check or Money Order Enclosed
*Do not put credit card information on this form. You may save payment information in your geauxBIZ profile under master account.
Business Name (List exactly as it appears in documents)
Name of person filing document (evidence of filing will be mailed to this person, at address below)
Address
State
City
Zip Code
Daytime phone number
Fax number
Email address
NOTE: Louisiana Law requires all Louisiana notaries to print or type their name and notary or
bar roll number on the document.
Mailing Address: P. O. Box 94125, Baton Rouge, LA * 70804-9125
Office Location: 8585 Archives Ave., Baton Rouge, LA * 70809
Web Site Address: www.sos.la.gov
SS984 Rev. 06/18
S
L
Commercial Division
TATE OF
OUISIANA
(225) 925-4704
S
S
ECRETARY OF
TATE
R. Kyle Ardoin
Fax Numbers
SECRETARY OF STATE
(225) 932-5314 Corporations
(225) 932-5317 Legal Services
(225) 932-5318 UCC
TRANSMITTAL INFORMATION
For All Business Filings
Please indicate below the level of service requested, payment and contact information
Routine
Expedite $30
Priority Expedite $50
24 hour processing
2-4 hour processing
Check or Money Order Enclosed
*Do not put credit card information on this form. You may save payment information in your geauxBIZ profile under master account.
Business Name (List exactly as it appears in documents)
Name of person filing document (evidence of filing will be mailed to this person, at address below)
Address
State
City
Zip Code
Daytime phone number
Fax number
Email address
NOTE: Louisiana Law requires all Louisiana notaries to print or type their name and notary or
bar roll number on the document.
Mailing Address: P. O. Box 94125, Baton Rouge, LA * 70804-9125
Office Location: 8585 Archives Ave., Baton Rouge, LA * 70809
Web Site Address: www.sos.la.gov
SS984 Rev. 06/18
R. Kyle Ardoin
Secretary of State
APPLICATION FOR A STATE CABLE & VIDEO FRANCHISE
(La. R.S. 45:1361)
Return to: Commercial Division
Enclose $60 filing fee
P.O. Box 94125
Make remittance payable to
Baton Rouge, LA 70804-9125
Secretary of State
(225) 925-4704
Do Not Send Cash
www.sos.la.gov
CHECK ONE: ( ) Original Filing
( ) Renewal
( ) Amendment
Company/Applicant Name
organized under the laws of the state of ______________________, county/parish of __________________
hereby agrees to maintain insurance in an amount not less than $1 million either through a policy of public
liability insurance or through self-insurance. The applicant agrees to comply with all applicable federal and
state laws and regulations.
Street address of principal place of business:
Names of the principal executive officers:
List of municipalities and/or parishes to be served:
(An addendum may be attached for additional municipalities/parishes.)
Title and Date
To be signed by an officer or general partner
On this ____ day of _____________, 20___, before me, personally appeared ___________________________,
to me known to be the person described in and who executed the foregoing instrument, and acknowledged that
he/she executed it as his/her free act and deed.
T100 Rev. 05/18
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