Form Cvd 53-44 - Certificate Of Conversion To A Kansas Entity - Secretary Of State
ADVERTISEMENT
1KANSAS SECRETARY OF STATE
CVD
Certificate of Conversion to
a Kansas Entity
53-44
Foreign or Kansas Entity Converting
into a Kansas Entity
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.
INSTRUCTIONS:
i
Please read instructions before completing.
Converting Entity
1. Business entity ID
number:
This is not the Federal Employer
_______________________________________
ID Number (FEIN)
2. Entity name:
_____________________________________________________________________________________
3. Type of entity:
___ For-Profit Corporation
___ General Partnership
___ Limited Liability Partnership
___ Not-for-Profit Corporation
___ Limited Liability Company
___ Limited Partnership
4. State or country of
organization:
_______________________________________
New Entity
5. Entity name:
_____________________________________________________________________________________
6. Type of entity:
___ For-Profit Corporation
___ General Partnership
___ Limited Liability Partnership
___ Not-for-Profit Corporation
___ Limited Liability Company
___ Limited Partnership
7. Effective date:
Upon filing
Future effective date (cannot exceed 90 days from the file date)
__________________________
Month
Day
Year
The formation document and fee for the converted entity are attached. This conversion is approved in accordance with
K.S.A. 17-78-401 through 17-78-406 or by the laws of the appropriate foreign jurisdiction.
I declare under penalty of perjury under the laws of the state of Kansas that the foregoing is true and correct and that I
have remitted the required fee.
____________________________________________________________
_______________________
Signature of authorized person of the converting entity
Date
____________________________________________________________
______________________________________
Name of signer, printed or typed
Title
i
Instructions:
1. Submit this form with the $75 filing fee. Make checks payable to the Kansas Secretary of State.
2. Include formation document for the new entity with the filing fee.
NOTICE:
There is a $25 service fee for all checks returned by your financial institution.
Page 1 of 1
K.S.A . 17-78-401 - K.S.A. 17-78-406
Rev. 12/27/10 jdr
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal