Form Dw 53-01 - For-Profit Corporation Dissolution By Written Consent (Page 2 of 2) in pdf

Form Dw 53-01 - For-Profit Corporation Dissolution By Written Consent Page 2

5. All stockholders with voting power do hereby consent to the dissolution of the corporation:

Stockholders’ signatures

____________________________________________ _______________________________________________

6. Effective date:

Upon ﬁ ling

A future effective date must be

within 90 days of ﬁ ling date

______________________________

Future effective date

Month

Day

Year

7. I, _______________________________________, declare under penalty of perjury under the laws of the state of

Name of ofﬁ cer

Kansas, that I am an ofﬁcer of the above-named corporation, that the above consent has been signed by or on behalf

of ALL stockholders entitled to vote on the dissolution, that the foregoing is true and correct and that I have remitted

the required fee.

________________________________________________________ ________________________________________________________

Signature of secretary or other ofﬁcer

Date (month, day, year)

________________________________________________________

Name of signer (printed or typed)

Instructions:

1. If this form is submitted after the close of the entity’s tax year, an annual report and fee must be ﬁled along with or

prior to dissolution. If the entity has forfeited, it must reinstate before dissolution.

2. Submit this form with the $35 filing fee.

STAY UP-TO-DATE ON YOUR ORGANIZATION’S STATUS, ANNUAL REPORT DUE DATE AND CONTACT ADDRESSES BY GOING TO

UNDER QUICK LINKS, SELECT SEARCH BUSINESS ENTITY INFORMATION.

There is a $25 service fee for all checks returned by your ﬁ nancial institution.

NOTICE:

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

Page 2 of 2

Rev. 6/01/10 nr

K.S.A . 17-6804

Form Dw 53-01 - For-Profit Corporation Dissolution By Written Consent Page 2