Form Rr - Certificate Of Corporation Reinstatement

Kansas Secretary of State

RR

Certificate of Corporation Reinstatement

All information must be completed or this document will not be accepted for filing.

1. The name of the corporation as it existed when the

corporation forfeited:

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

_______________________________________________________

2. Address of registered office in Kansas: (Address must

be a street address. A post office box is unacceptable.)

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Street Address

Do not write in this space

____________________________________________

City

State

Zip Code

Name of resident agent at the registered office: __________________________________________________________

3. The corporation was organized in the state of ______________________

4. The corporate existence or authority to engage in business in the state of Kansas: (Select one)

___ Has been forfeited for failure to timely file its annual report and pay its franchise tax.

___ Has expired or will expire on the _____ day of ______________, ________.

Is this corporation perpetual? Yes _____ No _____

If no, the term for which this corporation is to exist _________________.

___ 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/We (circle one) declare under penalty of perjury under the laws of the state of Kansas that the foregoing is true and

correct. Executed on the ________ of ___________, _____________.

Day

Month

Year

Attest:

_______________________________________ and ____________________________________________

President or Vice President

Secretary or Assistant Secretary

Both signatures are required

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