Our fees increased September 1, 2003. Please review
the instruction box on the form for the new fee.
Contact Information
KANSAS SECRETARY OF STATE
FA
Kansas Secretary of State
Foreign Corporation Application
Ron Thornburgh
Memorial Hall, 1st Floor
51
All information must be completed or this document will not be accepted for filing.
120 S.W. 10th Avenue
Topeka, KS 66612-1594
(785) 296-4564
Print
Reset
Please complete the form, print, sign
1. Name of the corporation:
and mail to the Kansas Secretary of
State with the filing fee. Selecting
______________________________________________
'Print' will print the form and 'Reset' will
Name of corporation must match the name on record with home state
clear the entire form.
2. State of organization: __________________________________
Do not write in this space
3. For profit
Not for profit
4. The date the corporation began doing business in Kansas, or intends to begin doing business in Kansas:
___________ ______ _______
OR
"upon qualification"
Month
Day
Year
5. The address of the corporation's principal office:
________________________________ __________________ ___________ _________ ____________
Street address
City
State
Zip
Country
6. The principal office or place of business in Kansas:
________________________________ ________________________ ________________ ____________
Street address
City
State
Zip
7. The address of the registered office in Kansas:
Kansas
________________________________
________________________ ________________
___________
Street address
City
State
Zip
and the name of the resident agent at the registered office address: _____________________________________________________
8. The nature of business to be conducted in the state of Kansas:
___________________________________________________________________________________________________________
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
9.
Officers: Name
Title
Address
City
State
Zip
Country
Page 1 of 3