Form Nw 53-13 - Not-For-Profit Corporation Dissolution By Written Consent
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1
2KANSAS SECRETARY OF STATE
NW
Not-For-Profit Corporation
53-13
Dissolution by Written Consent
Kansas Secretary of State, Chris Biggs
CONTACT:
Memorial Hall, 1st Floor
(785) 296-4564
120 S.W. 10th Avenue
Topeka, KS 66612-1594
Above space is for office use only.
All information must be completed or this document will not be accepted for filing.
INSTRUCTIONS:
i
Please read instructions before completing.
1. Business entity ID
number:
This is not the Federal Employer
_______________________________________
ID Number (FEIN)
2. Name of corporation:
Name must match the name on
record with the Secretary of State
________________________________________________________________________________________
3. Name and mailing
address of each officer:
1)
______________________________________________________________________________________
Do not leave blank
Name
If additional space is needed
_______________________________________________________________________________________
please provide an attachment
Mailing address
City
State
Zip
Country
2)
______________________________________________________________________________________
Name
__________________________________________________________________________________________
Mailing address
City
State
Zip
Country
3)
_____________________________________________________________________________________
Name
____________________________________________________________________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Mailing address
City
State
Zip
Country
4. Name and mailing
1)
______________________________________________________________________________________
address of the board of
directors:
Name
Do not leave blank
_______________________________________________________________________________________
If additional space is needed
Mailing address
City
State
Zip
Country
please provide an attachment
2)
______________________________________________________________________________________
Name
__________________________________________________________________________________________
Mailing address
City
State
Zip
Country
3)
_____________________________________________________________________________________
Name
____________________________________________________________________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Mailing address
City
State
Zip
Country
Page 1 of 2
Rev. 6/01/10 nr
K.S.A . 17-6804,
K.S.A. 17-6805
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