Form Pa 50 - Professional Corporation Annual Report
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1
2Contact Information
KANSAS SECRETARY OF STATE
PA
Kansas Secretary of State
Professional Corporation Annual Report
Ron Thornburgh
50
Memorial Hall, 1st Floor
120 S.W. 10th Avenue
All information must be completed and the required fee submitted or this
Topeka, KS 66612-1594
document will not be accepted for filing. Please read all instructions
(785) 296-4564
before completing this document.
1. Business Entity ID Number: _________________________________
(This is not the FEIN)
2. Corporation name: ________________________________________
________________________________________________________
3. Mailing address: __________________________________________
Address
Do not write in this space
________________________________________________________
City
State
Zip
4. Tax closing date: _____________________________
5. Federal Employer ID Number (FEIN): ________________________
Month
Day
Year
6. Officers (complete information for at least one position):
___________________________________________________________________________________________
Title
Name
Address
City
State
Zip
__________________________________________________________________________________________
___________________________________________________________________________________________
__________________________________________________________________________________________
7. Board of directors (entity must have at least one director):
___________________________________________________________________________________________
Name
Address
City
State
Zip
__________________________________________________________________________________________
___________________________________________________________________________________________
__________________________________________________________________________________________
Rev. 11/01/05 nr
K.S.A. 17-2718
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