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Professional Corporation Annual Report PA - Kansas
|Professional Corporation Annual Report Form. This is a Kansas form and can be used in For Profit Corporations Business Entities Secretary Of State .||
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PA 50 kansas secretary of state Kansas Professional Corporation Annual Report Instructions (785) 296-4564 firstname.lastname@example.org www.sos.ks.gov The following form must be complete and accompanied by the correct filing fee or the document will not be accepted for filing. Kansas Office of the Secretary of State: Memorial Hall, 1st Floor 120 S.W. 10th Avenue Topeka, KS 66612-1594 Save time and money by filing your annual report online at www.sos.ks.gov. There, you can also stay up-to-date on your organization's status, annual report due date, and contact addresses. o Filing fee The filing fee for the annual report is $55. If you are filing this annual report as part of a reinstatement due to forfeiture, you may owe a different fee (fees are listed with the reinstatement form). For more information, please call (785) 296-4564. Please enclose a check or money order payable to the Secretary of State. Forms received without the appropriate fee will not be accepted for filing. Please do not send cash. Notice: There is a $25 service fee for all checks returned by your financial institution. Also, to expedite processing, please do not use staples on your documents or to attach checks. This is the address where you would like to receive official mail from the Secretary of State's office. If your address has changed, check the box on the form, so that we may update our records with your new address. Annual reports are due on the 15th day of the fourth month following the tax closing month. eXAMPLe: If the tax closing month is December, the due date is April 15 of the following year. The annual report may be filed as early as January 1. If the annual report is not filed and the appropriate fee is not paid within 90 days following the due date, the business will be forfeited in Kansas. If the forfeited business wishes to return to active and good standing status, a reinstatement process is required and penalties will be assessed. eXAMPLe: If the tax closing month is December, the due date is April 15, and the forfeiture date is July 15. A business must file the annual report and pay the annual report fee on or before the forfeiture date to avoid forfeiture. If you wish to correct information that was erroneously provided on a previously filed annual report, you may file a Corrected Document form (form COR). Complete the form and attach a complete and correct new Annual Report (form PA) and submit with a $55 filing fee. If additional space is needed, please provide an attachment. o Payment o Mailing address o Due date o Forfeiture date o Corrected annual report Additional information o Inst. K.S.A. 17-2718 Rev. 9/12/11 jdr Please proceed to form. American LegalNet, Inc. www.FormsWorkFlow.com PA 50 kansas secretary of state Kansas Professional Corporation Annual Report Kansas Office of the Secretary of State: Memorial Hall, 1st Floor 120 S.W. 10th Avenue Topeka, KS 66612-1594 (785) 296-4564 email@example.com www.sos.ks.gov THIS SPACE FOR OFFICE uSE ONly. 1. Business entity ID number This is not the Federal Employer ID Number (FEIN). 2. Name of corporation Must match name on record with Kansas Secretary of State. Attention Name Address 3. Mailing address Address will be used to send official mail from the Secretary of State's Office. Do not leave blank. City State Zip Country o 4. Tax closing date 6. Total number of shares of capital stock issued 7. Name, title, and address of each officer of corporation Do not leave blank. Month Check this box if this is a new address. Our records will be updated only if this box is checked. Year 5. Federal Employer ID Number (FEIN) Name 1 Title If additional space is needed, please provide attachment. Address City State Zip Country Name 2 Title Address City State Zip Country Name 3 Title Address City State Zip Country 1/2 K.S.A. 17-2718 Rev. 9/12/11 jdr Please continue to next page. American LegalNet, Inc. www.FormsWorkFlow.com 8. Name and address of each member of board of directors of corporation Do not leave blank. Name 1 Address City State Zip Country If additional space is needed, please provide attachment. Name 2 Address City State Zip Country 9. Name and address of each shareholder Do not leave blank. Name 1 Address If additional space is needed, please provide attachment. City State Zip Country Name 2 Address City State Zip Country 10a. Is each officer, director, and shareholder listed above a qualified person as defined by law (K.S.A. 17-2707)? Only a qualified person may be a shareholder of a professional corporation (K.S.A. 17-2712). Exception: A certified public accountant (K.S.A. 1-308). No person may be a director or officer, other than the secretary, of a professional corporation unless that person is a shareholder (K.S.A. 17-2713). yes (Skip to 10c.) o o No (Proceed to 10b.) 10b. List those persons who are not qualified as defined by law. 10c. If any shares are owned by a nonqualified person, give the dates on which any shares were owned by a nonqualified person: 11. Indicate the types of professionals practicing through the corporation. o o o o o o o Architect Attorney-at-law Chiropractor Dentist Engineer Optometrist Osteopathic Physician or Surgeon o o o o o o o Veterinarian Podiatrist Pharmacist land Surveyor licensed Psychologist Specialist in Clinical Social Work Physician, Surgeon, or Doctor of Medicine o o o o o o o licensed Physical Therapist landscape Architect Registered Professional Nurse Clinical Professional Counselor Geologist Clinical Psychotherapist Real Estate Broker or Salesperson o o o o o o o Certified Public Accountant licensed Physician Assistant licensed Occupational Therapist licensed Audiologist licensed Speech Pathologist licensed Naturopathic Doctor Clinical Marriage and Family Therapist 12. 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 Authorized Officer X Month Day Year Name of Signer (printed or typed) Title/Position Phone Number 2/2 K.S.A. 17-2718 Rev. 9/12/11 jdr Please review to ensure completion American LegalNet, Inc. www.FormsWorkFlow.com .