Free RN.pmd - 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 Reinstatement
All information must be completed and the required fees submitted or this document will not be accepted for filing. Please read all instructions before completing this document.


RN
53-24

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1. Business Entity ID Number: ____________________________________

Reset

2. Name of the corporation:

____________________________________________________________
(Name must match 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.
Do not write in this space

3. Address of registered office in Kansas (a post office box is unacceptable): Kansas ______________________________________________ _______________________ ________ _________
Street Address City State Zip

4. Name of resident agent at the registered office: ______________________________________________________ 5. The corporation was organized in the state of: _______________________________________________________ 6. The corporate existence or authority to engage in business in the state of Kansas (SELECT ONLY ONE): ___ Has been forfeited for failure to timely file a correct annual report and/or pay the annual report fee or franchise tax. ___ Has expired or will expire on the _________ of _____________________, ____________.

Day Month Year


Is this reinstatement perpetual? Yes _____ No _____ If no, the term for which this corporation is to exist: _________ of _____________________, ____________.
Day Month Year

___ Has been forfeited for failure to designate or maintain a resident agent and registered office. This certificate is filed by the authority of duly elected directors or members of the governing body of the corporation in compliance with the provisions of K.S.A. 17-7002. I declare under penalty of perjury pursuant to the laws of the state of Kansas that the foregoing is true and correct and that I have remitted the required fees . Executed on the _________ of _____________________, ____________.
Day Month Year

Signature of authorized officer

Name of signer (printed or typed)

Phone number
Rev. 12/1/05 nr K.S.A. 17-7002 1/2

IMPORTANT INFORMATION Please read before completing your certificate of reinstatement
Please be aware that reinstating your business entity may be time consuming. Prepare for reinstatement by reviewing the instructions below. If you have questions after reading these instructions, please contact the Secretary of State's Office at (785) 296-4564.

1. Submit the form with the $20 filing fee. 2. Please refer to the following chart to find the correct fee for each year: Year ends: Prior and up to 1971 1972 to 1992 1993 to 2000 2001 to present Fee per year: No Fee $5 $20 $40

3. If more than three years of annual reports are past due, please only file the three most recent annual reports, but all annual report fees must be paid for each year past due. Make check or money order payable to the Kansas Secretary of State. Please do not send cash. 4. All past due annual reports and unpaid annual report fees must be filed with the certificate of reinstatement. Please make sure all documents and fees arrive in the Secretary of State's Office in the same envelope. 5. If the business name currently on file with the Secretary of State's Office is not available at the time of reinstatement, you may change the business name on the reinstatement form by following this instruction: On question 2, list the business name currently on file, and state that it is changing to a new name. For example: ABC, Inc. changing its name to DEF, Inc.

Notice: There is a $25 service fee for all checks returned by your financial institution.

Rev. 12/1/05 nr

K.S.A. 17-7002 2/2