Form Dpa 51-04 - Professional Association Articles Of Incorporation Page 2

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DPA
KANSAS SECRETARY OF STATE
Professional Association
51-04
Articles of Incorporation
Kansas Office of the Secretary of State
CONTACT:
Memorial Hall, 1st Floor
(785) 296-4564
120 S.W. 10th Avenue
kssos@sos.ks.gov
Topeka, KS 66612-1594
Above space is for office use only.
All information must be completed or this document will not be accepted for filing.
i
INSTRUCTIONS:
Please read instructions sheet before completing.
1. Name of the
corporation:
_____________________________________________________________________________________________
2. Name of the resident
agent and address of the
________________________________________________________________________________________
registered office in
Name
Street Address
Kansas:
Address must be a street address
______________________________________Kansas___________________________________________
A P.O. box is unacceptable
City
State
Zip
3. Mailing address:
Address will be used to send
________________________________________________________________________________________
official mail from the Secretary
Attention Name
Address
of State’s office
_______________________________________________________________________________________
City
State
Zip
Country
4. Tax closing month:
_______________________________________
5. State the professional
purpose:
________________________________________________________________________________________
6. Total number of
shares that this
__________ shares of __________ stock, class __________ par value of __________ dollars each
corporation is authorized
to issue:
__________ shares of __________ stock, class __________ par value of __________ dollars each
__________ shares of __________ stock, class __________ without nominal or par value
__________ shares of __________ stock, class __________ without nominal or par value
*If applicable, state any designations, powers, rights, limitations or restrictions applicable to any class
or any special grant of authority to be given to the board of directors:
________________________________________________________________________________________
Page 1 of 2
Rev. 12/27/10 jdr
K.S.A . 17-2709,
K.S.A. 17-6002

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