Kansas Voluntary Compliance Program Agreement Template
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STATE OF KANSAS
Lynn Jenkins, CPA
TELEPHONE
900 SW JACKSON ST. SUITE 201
TREASURER
TOPEKA, KANSAS 66612-1235
(785) 296-3171
Kansas Voluntary Compliance Program Agreement
The intent of the Voluntary Compliance Program offered by the Kansas State Treasurer is to bring
businesses into compliance with Kansas Unclaimed Property Laws.
Business Name __________________________________ Tax ID # ____________________
State of Incorporation ________________ Date of Incorporation _______/_______/_______
Contact Person _____________________________________Title _____________________
Contact Phone # _________________ Contact E-Mail _______________________________
Fax # _______________________________
A copy of the completed agreement will be faxed to you.
________________________________ (business name) intends to report and remit all unclaimed
property due to The State of Kansas for years covered in the *look-back period and the company will
develop procedures to ensure future compliance with Kansas Unclaimed Property Laws. The business
will examine their records, perform due diligence as required by law, prepare a report and deliver
unclaimed property to Kansas by _________________________________ (estimated date of delivery;
date should not exceed one year from the date of this agreement).
The administrator shall have discretion to waive the payment of penalties & interest as described in
KSA 58-3967 for businesses agreeing to participate in Kansas' Voluntary Compliance Program. A
business that fails to report property as required by this agreement may be subject to the assessment of
penalties & interest. Participation in this program does not protect your business from an audit.
Laws & guidelines pertaining to the report of unclaimed funds to the State of Kansas are accessible at
Contact the UCP Holder Department with any questions at
(785) 291-3173.
*Look-back period is 10 reporting years. If you have questions about this period please contact our office.
Return the signed agreement to: Unclaimed Property - Holder Services
900 SW Jackson, Suite 201
Topeka, KS 66612-1235
Authorized Business Representative __________________________________ Date _____________
KS Unclaimed Property Representative ________________________________ Date _____________
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