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Certificate Of Conversion To A Foreign Entity CVF - Kansas
| Certificate Of Conversion To A Foreign Entity Form. This is a Kansas form and can be used in Miscellaneous Secretary Of State . |
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CVF 53-45 CONTACT: Certificate of Conversion to a Foreign Entity Kansas Entity Converting into a Foreign Entity KANSAS SECRETARY OF STATE Kansas Office of the Secretary of State (785) 296-4564 kssos@sos.ks.gov www.sos.ks.gov Memorial Hall, 1st Floor 120 S.W. 10th Avenue Topeka, KS 66612-1594 Above space is for office use only. i All information must be completed or this document will not be accepted for filing. Please read instructions before completing. INSTRUCTIONS: Converting Entity 1. Business entity ID number: 2. Entity name: 3. Type of entity: This is not the Federal Employer ID Number (FEIN) _______________________________________ _____________________________________________________________________________________ ___ For-Profit Corporation ___ Not-for-Profit Corporation ___ General Partnership ___ Limited Liability Company ___ Limited Liability Partnership ___ Limited Partnership New Entity 4. Entity name: 5. Type of entity: 6. State or country of organization to which the entity is converted: _____________________________________________________________________________________ ___ For-Profit Corporation ___ Not-for-Profit Corporation ___ General Partnership ___ Limited Liability Company ___ Limited Liability Partnership ___ Limited Partnership _______________________________________ I hereby appoint the Kansas Secretary of State as agent for service of process. 7. Service of process may be delivered to: Must be a street address. A P.O. box is unacceptable. ______________________________________________________________________________________ Name Street Address ______________________________________________________________________________________ City State Zip Country 8. Effective date: Upon filing Future effective date (cannot exceed 90 days from the file date) __________________________ Month Day Year Rev. 12/27/10 jdr Page 1 of 2 K.S.A. 17-78-401 - K.S.A. 17-78-406 American LegalNet, Inc. www.FormsWorkFlow.com This conversion is approved in accordance with K.S.A. 17-78-401 through 17-78-406 and amendments thereto. 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. If the tax closing month has passed, please submit an annual report and fee along with this form. NOTICE: Rev. 12/27/10 jdr There is a $25 service fee for all checks returned by your financial institution. Page 2 of 2 K.S.A. 17-78-401 - K.S.A. 17-78-406 American LegalNet, Inc. www.FormsWorkFlow.com
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