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Form Nro 53-13 - Change Of Registered Office Or Agent By A Not-For-Profi T Corporation Page 2

KANSAS SECRETARY OF STATE

NRO

Change of Registered Ofﬁce or Agent

by a Not-For-Proﬁ t Corporation

53-13

Kansas Secretary of State, Chris Biggs

CONTACT:

Memorial Hall, 1st Floor

(785) 296-4564

120 S.W. 10th Avenue

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.

INSTRUCTIONS:

Please read instructions sheet before completing.

1. Business entity ID

number:

This is not the Federal Employer

_______________________________________

ID Number (FEIN)

2. Name of corporation:

Name must match the name on

________________________________________________________________________________________

record with the Secretary of State

3. State/Country of

organization:

_______________________________________

4. The new name of the

________________________________________________________________________________________

resident agent and

address of the registered

Name

Street Address

ofﬁce in Kansas:

______________________________________________________________________________________

Kansas

Address must be a street address

A P.O. box is unacceptable

City

State

Zip

5. I declare under penalty of perjury under the laws of the state of Kansas that the foregoing is true and correct and

that I have remitted the required fee.

________________________________________________________ ________________________________________________________

Signature of authorized ofﬁcer

Date (month, day, year)

________________________________________________________

Name of signer (printed or typed)

Page 1 of 1

Rev. 6/01/10 nr

K.S.A . 17-6203

Form Nro 53-13 - Change Of Registered Office Or Agent By A Not-For-Profi T Corporation Page 2

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