Certificate Of Corporate Correction Form - 2001

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Kansas Secretary of State
CC
Certificate of Corporate Correction
All information must be completed or this document will not be accepted for filing.
1. Name of the corporation
_________________________________________
Name must match the name on record with the Secretary of State
2. State of incorporation: _______________________
3. Specify the document and the inaccuracy that is to be
corrected:
__________________________________________
__________________________________________
__________________________________________
__________________________________________
Do not write in this space
4. Set forth the portion of the document in its corrected form:
__________________________________________
__________________________________________
__________________________________________
__________________________________________
I 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: ____________________________________
President or Vice President
Secretary or Assistant Secretary
Please submit this form in duplicate with the $20 filing fee.
Contact Information
Kansas Secretary of State
Ron Thornburgh
Memorial Hall, 1st Floor
120 SW 10th Avenue
Topeka, KS 66612-1240
785-296-4564
Rev. 7/01 hb
K.S.A. 17-6003

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