Form Bt 50 - Business Trust Annual Report Page 2
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1
2kansas secretary of state
Bt
Business trust
Annual Report
50
Kansas Office of the Secretary of State:
Memorial Hall, 1st Floor
(785) 296-4564
120 S.W. 10th Avenue
kssos@sos.ks.gov
Topeka, KS 66612-1594
THIS SPACE FOR OFFICE uSE ONlY.
1. Business entity iD #
This is not the Federal Employer ID
Number (FEIN).
2. Business trust name
Must match name on record with
Kansas Secretary of State.
3.
Mailing address
Attention Name
Address
Address will be used to
send official mail from the
Secretary of State’s Office.
City
State
Zip
Country
Do not leave blank.
o
Check this box if this is a new address. Our records will be updated only if this box is checked.
4.
Principal office address
Street Address
Must be a street, rural route,
or highway. A P.O. box is
City
State
Zip
Country
unacceptable.
5.
tax closing date
6.
State of incorporation
Month
Year
7.
Name and address of
Name 1
Address
each trustee as of end
of tax period
City
State
Zip
Country
If additional space is needed,
please provide attachment.
Do not leave blank.
Name 2
Address
City
State
Zip
Country
Name 3
Address
City
State
Zip
Country
8.
Federal Employer Identification Number (FEIN)
9.
I declare under penalty of perjury pursuant to the laws of the state of Kansas that the foregoing is true and
correct and that I have remitted the required fee.
Signature of Trustee or other Authorized Officer
Month
Day
Year
X
Name of Signer (printed or typed)
Title/Position
Phone Number
1 / 1
Please review to ensure completion.
K.S.A. 17-2036
Rev. 9/12/11 jdr
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