Form Dbt 51-07 - Kansas Business Trust Application Page 2
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3DBT
KANSAS SECRETARY OF STATE
Kansas Business Trust
51-07
Application
Kansas Office of the Secretary of State
CONTACT:
Memorial Hall, 1st Floor
(785) 296-4564
120 S.W. 10th Avenue
kssos@sos.ks.gov
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.
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INSTRUCTIONS:
Please read instructions sheet before completing.
1. Name of the business
trust:
_____________________________________________________________________________________________
2. Name of the resident
agent and address of the
________________________________________________________________________________________
registered office in
Name
Street Address
Kansas:
Address must be a street address
______________________________________Kansas___________________________________________
A P.O. box is unacceptable
City
State
Zip
3. Mailing address:
Address will be used to send
________________________________________________________________________________________
official mail from the Secretary
Attention Name
Address
of State’s office
_______________________________________________________________________________________
City
State
Zip
Country
4. Tax closing month:
_______________________________________
5. Name and mailing
address of the trustees:
1)
_______________________________________________________________________________________
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
______________________________________________________________________________________
4)
Name
_________________________________________________________________________________________
Mailing address
City
State
Zip
Country
Page 1 of 2
Rev. 3/31/11 jdr
K.S.A . 17-2030
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