Form Cr-18 - Kansas Ownership Change Form
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1KANSAS OWNERSHIP CHANGE FORM
RCN - FOR OFFICE USE ONLY
Name of business: _____________________________________________________
EIN: ___ ___ __ ___ ___ ___ ___ ___ ___
Complete the following information so your customer profile can be maintained with the most current information. You may copy
this form is more space is needed. Important—If a business fails to report or pay appropriate state taxes, any individual who is
responsible for the tax authorizes the Secretary of Revenue to research the credit history of the business or that individual.
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Check the appropriate box:
Adding a name
Removing a name
__________________________________________________
_______________________________________________
Printed full proper name of Owner, Partner, or Corporate Officer
Signature of Owner, Partner, or Corporate Officer
SSN / EIN
Title ____________________________________________
(Check one) ____________________________________
Home address
(street, city, state, zip code) ___________________________________________________________________________
Home phone _____________________ Email ___________________________________ Percent of Ownership ______ %
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Do or did you have control or authority over how business funds or assets are spent?
Yes
No
Date you became the owner, partner, corporate officer or LLC member; or the effective date to remove your name as the owner,
partner, corporate officer or LLC member of this business. Month ________ Day ________ Year ________
ˆ
ˆ
Check the appropriate box:
Adding a name
Removing a name
__________________________________________________
_______________________________________________
Printed full proper name of Owner, Partner, or Corporate Officer
Signature of Owner, Partner, or Corporate Officer
SSN / EIN
Title ____________________________________________
(Check one) ____________________________________
Home address
(street, city, state, zip code) ___________________________________________________________________________
Home phone _____________________ Email ___________________________________ Percent of Ownership ______ %
ˆ
ˆ
Do or did you have control or authority over how business funds or assets are spent?
Yes
No
Date you became the owner, partner, corporate officer or LLC member; or the effective date to remove your name as the owner,
partner, corporate officer or LLC member of this business. Month ________ Day ________ Year ________
ˆ
ˆ
Check the appropriate box:
Adding a name
Removing a name
__________________________________________________
_______________________________________________
Printed full proper name of Owner, Partner, or Corporate Officer
Signature of Owner, Partner, or Corporate Officer
SSN / EIN
Title ____________________________________________
(Check one) ____________________________________
Home address
(street, city, state, zip code) ___________________________________________________________________________
Home phone _____________________ Email ___________________________________ Percent of Ownership ______ %
ˆ
ˆ
Do or did you have control or authority over how business funds or assets are spent?
Yes
No
Date you became the owner, partner, corporate officer or LLC member; or the effective date to remove your name as the owner,
partner, corporate officer or LLC member of this business. Month ________ Day ________ Year ________
CR-18 (Rev. 10/13)
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