Contact Information
KANSAS SECRETARY OF STATE
FL
Kansas Secretary of State
Foreign Limited Liability Company Application
Ron Thornburgh
51
Memorial Hall, 1st Floor
All information must be completed and the required fees submitted
120 S.W. 10th Avenue
or this document will not be accepted for filing. Please read all
Topeka, KS 66612-1594
instructions before completing this document.
(785) 296-4564
Print
Reset
Please complete the form, print, sign and
mail to the Kansas Secretary of State with
1. Name of the limited liability company:
the filing fee. Selecting 'Print' will print the
form and 'Reset' will clear the entire form.
___________________________________________________________
Name must match the name on record with the home state
Do not write in this space
2. State of organization: ________________________________________
3. The date of its organization in home state: _____________ ______ _________
Month
Day
Year
4. The date on which the foreign LLC first did or intends to do business in Kansas:
_____________ ______ _________
OR
"upon qualification" ___
Month
Day
Year
5. The nature and character of business to be conducted in the state of Kansas:
__________________________________________________________________________________________
__________________________________________________________________________________________
6. The address of the registered office in Kansas (a post office box is unacceptable):
Kansas
_____________________________________________
_______________________
_______________ ____________
Street address
City
State
Zip
and the name of the resident agent at the registered office address: ___________________________________________
7. The address where you would like to receive official mail from the Secretary of State’s Office (if no address is given, mail will be sent
to the LLC’s registered office):
_____________________________________________
_______________________
_______________ ____________
Street address
City
State
Zip
Official mail should be addressed to the following individual: ________________________________________________
(Optional)
Rev. 9/1/06 nr
K.S.A. 17-76,121
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