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                    kansas secretary of state       
                    Certificate of Revival
            RR      Corporation and Business Trust

                                                                                           SUBMIT THE DOCUMENTS 
                                                                                                WITHOUT THIS PAGE
            INSTRUCTIONS FOR FILING 

            CERTIFICATE OF REVIVAL

Note: All documents filed by the Secretary of State’s office are considered public record and may be viewable online.

How to complete the certificate of revival for a corporation or                 Domestic corporations and business trusts only: 
business trust:                                                                 If the business entity is a domestic corporation or domestic business 
                                                                                trust and the name is currently in use, the corporation or business trust 
Each of the numbered instructions below corresponds to a section on             will need to choose one of two options:
the form.
                                                                                a.  Submit the certificate of revival with a letter of consent.
1.  List the business entity’s ID number issued by the Kansas 
            Secretary of State (This is not a tax ID number). ID numbers may    Letter of consent: Pursuant to K.S.A. 17-7933, the letter of 
            be found by clicking on Business Entity Database at https://www.    consent must include an indication that the current business 
            kansas.gov/bess/.                                                   entity consents to the use of the name. This letter must be 
                                                                                executed by an authorized person for the current business entity 
2.  Provide the complete legal business entity name, including words            registered.
            of formation (e.g., Inc., Corp., etc.)
                                                                                b.  Provide the current name, indicate that the entity’s name has 
            Check to see if the name of the covered business entity is in use   changed, and provide the new name of the business entity.
            by any other entity already registered with our office online at 
            https://www.kansas.gov/bess/.                                       3.  Provide the name the business entity was originally registered with 
                                                                                as a corporation or business trust. To view any documents filed 
            Foreign corporations and business trusts only:                      with our office, perform a business search online at http://www.
            If the business entity is a foreign corporation or foreign business kansas.gov/bess/ and click on Business Entity Database.
            trust and the name is currently in use, the corporation or business 
            trust will need to choose one of three options:                     4.  Provide the date the original articles of incorporation or business 
                                                                                trust application were filed. To find the date the original articles of 
            a.  Submit the certificate of revival with a letter of consent.     incorporation or business trust application were filed, perform a 
                                                                                business search online at http://www.kansas.gov/bess/ and click 
            Letter of consent: Pursuant to K.S.A. 17-7933, the letter of        on Business Entity Database.
            consent must include an indication that the current business 
            entity consents to the use of the name. This letter must be         5.  Provide the date the articles of incorporation or business trust 
            executed by an authorized person for the current business           were forfeited or void. To find the date the articles of incorporation 
            entity registered.                                                  or business trust application became forfeited or void, perform a 
                                                                                business search online at http://www.kansas.gov/bess/ and click 
            b.  Submit the certificate of revival with a letter of advertising. on Business Entity Database.
            Letter of advertising: Pursuant to K.S.A. 17-7933, a letter of      6.  Provide the name of the resident agent.
            advertising must indicate that, in all means of identification and 
            advertising, the business entity will identify as an entity out of  Resident agent: This is either an individual or a business entity 
            their foreign (non-Kansas) state. If the current covered entity is  registered in Kansas (may be the business entity the certificate 
            domesticated in the same foreign state, a letter of advertising     of revival is for) who will receive any legal documents (e.g., 
            can’t be used and a letter of consent from the current business     subpoenas, court orders, summons, etc.) for the business entity 
            entity must be provided.                                            named in section 2. If the resident agent is a business entity, 
                                                                                search for the legal name of the business at https://www.kansas.
            c.  Provide the current name, indicate that the business entity’s   gov/bess/.
            name has changed, and provide the new name of the business 
            entity.                                                             7.  Provide the registered office for the resident agent.
                                                                                Registered office: Must be an address in Kansas where the 
                                                                                resident agent may be regularly present. The address must include 
                                                                                the building number, street, city, state, and zip code. This can’t be 
                                                                                a PO box.
                                                                                8.  An authorized person on behalf of the entity must sign.

            K.S.A. 17-7002                                                                      Please continue to next page.
Inst.       Rev. 7/25/23 tc



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Please
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               kansas secretary of state   
               Certificate of Revival
            RR Corporation and Business Trust

                                                                                            SUBMIT THE DOCUMENTS 
                                                                                                     WITHOUT THIS PAGE
            INSTRUCTIONS FOR FILING 

            CERTIFICATE OF REVIVAL

Note: All articles filed by the Secretary of State’s office are considered public record and may be viewable online.

Fee Schedule                                                                 Mail to:

Certificate of Revival                                                       Kansas Secretary of State
                                                                             Memorial Hall, 1st Floor
The filing fee for the certificate of revival is as follows:                 120 SW 10th Avenue
                                                                             Topeka KS 66612
Corporation:
   For-profit: .................................................... $35
                                                                             Checks and credit/debit cards are accepted for payment. Make checks 
   Not-for-profit:  ............................................... $20
                                                                             payable to the Kansas Secretary of State. Once processing the 
Business Trust: .............................................. $35
                                                                             certificate of revival is completed, a certified copy of the certificate of 
                                                                             revival will be mailed to the address of the sender.
The annual reports and filing fees for each must also accompany the 
certificate of revival. See the Annual Report Fee Schedule on the next 
page for more details.                                                       Or

                                                                             Fax to:
For-profit corporations and business trusts only:
                                                                             Business Services at (785) 296-4570
For for-profit corporations or business trusts that forfeited for failure to 
                                                                             Faxing the document will incur a fee of $20 in addition to the filing fee 
file an annual report on-time, a one-time penalty fee of $85 must be 
                                                                             listed above.
included. For corporations or business trusts who forfeited for failure to 
maintain a resident agent, there isn’t a penalty fee.
                                                                             The following cover page indicating credit/debit card and contact 
                                                                             information must be submitted with the documents. All documents must 
Not-for-profit corporations do not pay a penalty fee regardless of the 
                                                                             be submitted together and filing fees for both the annual report(s) and 
reason for forfeiture.
                                                                             certificate of revival will be processed using the credit card.

                                                                             Faxed documents received without errors before 4:00 p.m. (Central 
                                                                             Time) will receive that day’s filing date. Once processing the certificate 
                                                                             of revival are completed, a certified copy of the certificate of revival will 
                                                                             be mailed to the address of the sender.

            K.S.A. 17-7002                                                                            Please proceed to form.
Inst.       Rev. 7/25/23 tc



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                            ANNUAL REPORT 
            RR
                            FEE SCHEDULE

For-profit corporations and business trusts (use annual report Form AR):

            To determine fees and/or franchise taxes owed, please refer to the chart below for the tax years for which the corporation or 
            business trust is filing past due annual reports.

            Annual reports with tax year ending DECEMBER 2004 TO PRESENT:

            Fee amount:               $55 flat filing fee

            Annual reports with tax year ending 2001 TO NOVEMBER 2004:

            Franchise tax calculation: $2 for every $1,000 of net worth

            Minimum amount:           $55
            Maximum amount:           $5015

            Annual reports with tax year ending PRIOR AND UP TO 2000:

            Franchise tax calculation: $1 for every $1,000 of net worth

            Minimum amount:           $35
            Maximum amount:           $2515

Not-for-profit corporations (use annual report Form NP):
            To determine fees owed, please refer to the chart below for the tax years for which the corporation is filing past due annual 
            reports. Not-for-profit corporations are required to only file the annual reports for the three most recent reporting periods, but 
            shall pay all fees due from the date of forfeiture.

            Annual reports with tax year ending 2001 TO PRESENT:

            Fee amount:               $40 flat filing fee

            Annual reports with tax year ending 1993 TO 2000:

            Fee amount:               $20 flat filing fee

            Annual reports with tax year ending 1972 TO 1992:

            Fee amount:               $5 flat filing fee

            Annual reports were not required for not-for-profit corporations PRIOR TO 1972.

            K.S.A. 17-7002
Inst.       Rev. 7/25/23 tc



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               kansas secretary of state   
               Certificate of Revival
            RR Corporation and Business Trust

                           COVER PAGE 

            CERTIFICATE OF REVIVAL

Note: The credit/debit card information will be destroyed upon the filing of the document. Submit this page with the 
document when faxing documents to the Secretary of State’s office.

Contact Information

            Contact Person

            Direct Phone Number for Contact Person

Payment Information (Credit/Debit card must be provided when faxing documents to our office)

            Credit/Debit Card Number

            Expiration Date (MM/YY)

            Billing Zip Code

            K.S.A. 17-7002
Inst.       Rev. 7/25/23 tc



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                          kansas secretary of state                                      Print                                Reset
                          Certificate of Revival                                                                                                 
            RR            Corporation and Business Trust                                 Please complete the form, print, sign and mail to the 
                                                                                         Kansas Secretary of State with the filing fee.  Selecting 
                                                                                         'Print' will print the form and 'Reset' will clear the entire 
                                                                                                  form.
      Memorial Hall, 1st Floor                  (785) 296-4564                                    For-Profit 53-08
      120 S.W. 10th Avenue                      kssos@ks.gov                                   Not-For-Profit 53-24
      Topeka, KS 66612-1594                     https://sos.ks.gov                             THIS SPACE FOR OFFICE USE ONLY.

Note: The certificate of revival must be submitted with all annual reports and fees due from the time of forfeiture.  
(See instructions for details.)

1.   Business entity ID number:
            Kansas Secretary of State issued 
            file number.

2.   Current name of corporation 
            or business trust:
            Must match name on record with 
            the Secretary of State at the time 
            of forfeiting.

3.   Name the entity originally 
            registered with as a 
            corporation or business trust:
            Leave blank if same as section 2.

4.   Date of filing the entity’s                Month          Day Year
            articles of incorporation or 
            business trust application:

5.   Date the articles of                       Month          Day Year
            incorporation or business 
            trust application became 
            forfeited:

6.   Name of resident agent:
            Must be an individual, the business 
            entity named in section 2, or an 
            entity already registered with our 
            office. Do not leave blank.

7.   Registered office in Kansas                Street Address (A PO box is unacceptable)
            for the resident agent:
            Must be a street, rural route, 
            or highway. A. PO box is            City                                     State Zip
            unacceptable.
                                                                                         KS

Pursuant to K.S.A. 17-7002(d)(3), the corporation desiring to be revived and reviving its corporate existence was duly 
organized under the laws of the state of its original incorporation.

The certificate of revival is filed by authority of the board of directors or members of the governing body of the 
corporation in accordance with K.S.A. 17-7002(h).

      8.   I declare under penalty of perjury pursuant to the laws of the state of Kansas that the foregoing is true and correct. 

      Signature of Authorized Person

      X

                    K.S.A. 17-7002                                                             Please review to ensure completion.
1 / 1               Rev. 7/25/23 tc






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