Thank you for submitting your Annual Report Filing!

Contact Information

Name: {{ $report->first_name }} {{ $report->last_name }}

Address: {{ $report->address }}, {{ $report->suite }}

City, State, Zip: {{ $report->city_state_zip }}

Phone: {{ $report->phone }}

Fax: {{ $report->fax }}

Email: {{ $report->email }}

Company Information

Name of Entity: {{ $report->entity_name }}

Type of Entity: {{ $report->entity_type }}

State of Formation: {{ $report->state_formation }}

Date of Formation: {{ $report->date_formation }}

Shareholder/Officer Information

Shareholder 1 - Full Name: {{ $report->shareholder_name }}

Shareholder 1 - Residence Address: {{ $report->shareholder_address }}

Shareholder 1 - Phone: {{ $report->shareholder_phone }}

Shareholder 1 - Fax: {{ $report->shareholder_fax }}

Credit Card Authorization

Card Type: {{ $report->card_type }}

Name on the Credit Card: {{ $report->card_name }}

Credit Card Number: **** **** **** {{ substr($report->card_number, -4) }}

Expiration Date: {{ $report->card_expiration }}

Security (CSV) Code: ***

Billing Address: {{ $report->billing_address }}

City, State, Zip: {{ $report->billing_city_state_zip }}

We have successfully received your filing and will process it soon.