Contact Information
KANSAS SECRETARY OF STATE
EC
Kansas Secretary of State
Electric Cooperative Annual Report
Ron Thornburgh
50
Memorial Hall, 1st Floor
All information must be completed or this document will not be accepted for filing.
120 S.W. 10th Avenue
Topeka, KS 66612-1594
(785) 296-4564
Print
Reset
Please complete the form, print, sign and
Electric cooperative name:
mail to the Kansas Secretary of State with
the filing fee. Selecting 'Print' will print
Mailing address:
the form and 'Reset' will clear the entire
Street address
form.
City
State
Zip
Do not write in this space
Electric cooperative ID number:
Tax closing date:
Month
Day
Year
Due date:
Month
Day
Year
Telephone number:
Federal employer ID number:
1. Complete the balance sheet of the cooperative for the tax year ending:
Month
Day
Year
ASSETS
LIABILITIES AND
AMOUNT TOTAL
SHAREHOLDERS' EQUITY
AMOUNT TOTAL
a. Cash
o. Accounts payable
b. Trade notes & accounts receivable
p. Mortgages, notes, bonds
-less allowance for bad debts
payable in less than one year
c. Inventories
q. Other current liabilities
d. Government obligations
r. Loans from shareholders
-U.S. and instrumentalities
s. Mortgages, notes, bonds
-State, subdivisions thereof, etc.
payable in one year or more
e. Other current assets
t. Other liabilities
f. Loans to shareholders
u. Total liabilities
g. Mortgages and real estate loans
v. Capital stock:
h. Other investments
-preferred stock
i. Buildings and other fixed
-common stock
depreciable assets
w. Paid-in or capital surplus
-less accumulated depreciation
x. Retained earnings - appropriated
j. Depletable assets
y. Retained earnings income
-less accumulated depreciation
fund - unappropriated
k. Land (net of any amortization)
z. Less cost of treasury stock
l. Intangible assets (amortizable only)
aa.Net worth (total shareholders' equity)
- less accumulated amortization
m. Other assets
bb.TOTAL LIABILITIES AND
n. TOTAL ASSETS
SHAREHOLDERS' EQUITY
(Lines n. and bb. must be identical)
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