Form Bt 50 - Business Trust Annual Report - Kansas Secretary Of State
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1Contact Information
KANSAS SECRETARY OF STATE
BT
Kansas Secretary of State
Business Trust Annual Report
Ron Thornburgh
Memorial Hall, 1st Floor
50
120 S.W. 10th Avenue
All information must be completed and the required fee submitted or this
Topeka, KS 66612-1594
document will not be accepted for filing. Please read all instructions before
(785) 296-4564
completing this document.
1. Business Entity ID Number: _________________________________
(This is not the FEIN)
2. Business trust name: ______________________________________
_________________________________________________________
(Name must match the name on record with the Secretary of State)
3. Tax closing date: ____________________________________
Month
Day
Year
Do not write in this space
4. Mailing address (this address will be used to send official mail from the
Secretary of State’s Office):
______________________________________________________________________________________________________
Address
City
State
Zip
5. Principal office address (must be a street, rural route or highway; a P.O. box is unacceptable):
______________________________________________________________________________________________________
Address
City
State
Zip
6. State of incorporation: ________________________
7. Federal Employer ID Number (FEIN): _________________________
8. List the names and addresses of trustees as of the end of tax period:
______________________________________________________________________________________________________
Name
Address
City
State
Zip
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
9. I declare under penalty of perjury pursuant to the laws of the state of Kansas that the foregoing is true and correct and that I have
remitted the required fee. (Do not leave blank.)
Signature of trustee or other authorized officer
Date (month, day, year)
Name of trustee (printed or typed)
Phone number
Rev. 12/1/07 nr
K.S.A. 17-2036
1/2
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