kansas secretary of state
AR
For-Profit Corporation
Annual Report
50
Kansas Office of the Secretary of State:
Memorial Hall, 1st Floor
(785) 296-4564
120 S.W. 10th Avenue
kssos@sos.ks.gov
Topeka, KS 66612-1594
THIS SPACE FOR OFFICE USE ONLY.
1.
Business entity ID #
This is not the Federal Employer ID
Number (FEIN).
2.
Name of corporation
Must match name on record with
Kansas Secretary of State.
3.
Mailing address
Attention Name
Address
Address will be used to
send official mail from the
City
State
Zip
Country
Secretary of State’s Office.
Do not leave blank.
o
Check this box if this is a new address. Our records will be updated only if this box is checked.
4.
Principal office address
Street Address
Must be a street, rural route,
or highway. A P.O. box is
City
State
Zip
Country
unacceptable.
5.
Tax closing date
6.
State of incorporation
Month
Year
7.
Name, title, and
Name 1
Title
address of each
officer of corporation
Address
If additional space is needed,
please provide attachment.
Do not leave blank.
City
State
Zip
Country
Name 2
Title
Address
City
State
Zip
Country
Name 3
Title
Address
City
State
Zip
Country
1 / 2
Please continue to next page.
K.S.A. 17-7503, 17-7505
Rev. 9/12/11 jdr