Form Rr 53-08 - Corporation Certificate Of Reinstatement
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1Contact Information
KANSAS SECRETARY OF STATE
RR
Kansas Secretary of State
Corporation Certificate of Reinstatement
Ron Thornburgh
53-08
Memorial Hall, 1st Floor
All information must be completed and the required fees submitted or this
120 S.W. 10th Avenue
document will not be accepted for filing. Please read all instructions
Topeka, KS 66612-1594
before completing this document.
(785) 296-4564
Print
Reset
1. Business Entity ID Number: ____________________________________
Please complete the form, print, sign
and mail to the Kansas Secretary of
2. Name of the corporation:
State with the filing fee. Selecting
'Print' will print the form and 'Reset'
will clear the entire form.
____________________________________________________________
(Name must match name on record with the Secretary of State)
Do not write in this space
3. Address of registered office in Kansas (a post office box is unacceptable):
Kansas
______________________________________________ _______________________ ________ _________
Street Address
City
State
Zip
4. Name of resident agent at the registered office: ______________________________________________________
5. The corporation was organized in the state of: _______________________________________________________
6. The corporate existence or authority to engage in business in the state of Kansas (SELECT ONLY ONE):
___ Has been forfeited for failure to timely file a correct annual report and/or pay the annual report fee or franchise tax.
___ Has expired or will expire on the _________ of _____________________, ____________.
Day
Month
Year
Is this reinstatement perpetual? Yes _____ No _____
If no, the term for which this corporation is to exist: _________ of _____________________, ____________.
Day
Month
Year
___ 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 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 fees.
Executed on the _________ of _____________________, ____________.
Day
Month
Year
Name of signer (printed or typed)
Signature of authorized officer
Phone number
Rev. 12/1/05 nr
K.S.A. 17-7002
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