Free NCC 04.p65 - Kansas

Contact Information
Kansas Secretary of State Ron Thornburgh Memorial Hall, 1st Floor 120 S.W. 10th Avenue Topeka, KS 66612-1594
(785) 296-4564
[email protected]
www.kssos.org


KANSAS SECRETARY OF STATE

Not for Profit Corporation Certificate of Correction
All information must be completed or this document will not be accepted for filing.

NCC
53-13

Print

Reset

1. Name of the corporation: _______________________________________________________
Name must match the name on record with the secretary of state

Please complete the form, print, sign and mail to the Kansas Secretary of State with the filing fee. Selecting 'Print' will print the form and 'Reset' will clear the entire form.

2. State of incorporation: ___________________________________
Do not write in this space

3. Specify the document and the inaccuracy that is to be corrected: ___________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ 4. Set forth the portion of the document in its corrected form: ____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________

I declare under penalty of perjury under the laws of the state of Kansas that the foregoing is true and correct. Executed on the ________ of ___________ , _________ .
Day Month Year

Authorized officer

Instruction Submit this form with the $20 filing fee.
Notice: There is a $25 service fee for all returned checks.

Rev. 12/07/04 amc Rev. 8/26/03 jb K.S.A. 17-6003