PDF document

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Please
Do NotStaple
kansas secretary of state
Annual Report
NP Not-for-Profit Corporation

SUBMIT THE DOCUMENTS
WITHOUT THIS PAGE
INSTRUCTIONS FOR FILING

AN ANNUAL REPORT

Note: All documents filed by the Secretary of State’s office is considered public record and may be viewable online. File
this document directly online at https://www.kansas.gov/annual-reports/index.do.

How to complete the annual report for a not-for-profit corporation: 6b. Provide both the Business Entity name and the Kansas Secretary
of State ID number for each entity that the corporation owns a
Each of the numbered instructions below corresponds to a section on majority ownership in. Both fields must be completed.
the form.
7. Provide an indication if the entity owns land suitable for agricultural
1. List the entity’s ID number issued by the Kansas Secretary of use. Complete the form AG if answered yes or disregard the form
State (this is not a tax ID number). ID numbers may be found by AG if answered no.
clicking on Business Entity Database at https://www.kansas.gov/
bess/. 8. An authorized person on behalf of the entity must sign.
2. Provide the complete legal entity name, including words of
formation (e.g., LLC, Inc., etc.) AG - Annual Report Agricultural Attachment Instructions
1. Each tract or lot must be detailed in this section. This includes
3. Provide the principal office of the entity.
a numerical response for the location, indicate if the land was
acquired after July 1st, 1981, a brief description of how the land is
Principal office: Must be a physical address that must include the
used, and an indication if the land is owned or leased.
building number, street, city, state, and zip code. This can’t be a PO
box.
2. Respond to each of the categories if applicable. At least one of the
categories must have a numerical response.
4. Provide the tax closing date for the annual report. Annual reports
are filed after a tax year end has passed and represent the
3. A numerical response must be provided, even if zero.
information that is true for that year end only (example: when an
entity’s tax year ends on the last day of December, the annual
4. Respond to each of the categories if applicable. At least one
report due date period would be between January 1st and June
category with the value and location must have a response.
15th after each December. The report should reflect December for
the month).

5a. Each name of the officer of the corporation must be listed along
with a title for the officer and the address where they may be
regularly located.

5b. Provide each name of the members of the governing body of the
corporation along with the address where they may be regularly
located. The directors may be omitted if the officers are the same
individuals.

6a. Provide an indication of if the entity holds a majority ownership in
any other business that is currently filed with the Kansas Secretary
of State’s Office. Continue with section 6b if answered yes or
continue with section 7 if answered no.

K.S.A. 17-7504 Please continue to next page.
Inst. Rev. 6/16/23 tc

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Please
Do NotStaple
kansas secretary of state
Annual Report
NP Not-for-Profit Corporation

SUBMIT THE DOCUMENTS
WITHOUT THIS PAGE
INSTRUCTIONS FOR FILING

AN ANNUAL REPORT

Fee Schedule Mail to:

Annual Report Kansas Secretary of State
Memorial Hall, 1st Floor
The filing fee for the annual report is as follows: 120 SW 10th Avenue
Topeka KS 66612
Online Annual Report: ................................... $40
Paper Annual Report: .................................... $40
Only checks are accepted for payment. Make checks payable to the
Kansas Secretary of State.
Filing Online
Or
The annual report may be filed directly online at https://www.kansas.
gov/annual-reports/index.do. Fax to:

This form can’t be faxed unless it is being filed as part of another filing
(i.e., reinstatement, corrected document, foreign application, etc.) See
the fax instructions with the other document for details.

K.S.A. 17-7504 Please proceed to form.
Inst. Rev. 6/16/23 tc

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Please
Do NotStaple
kansas secretary of state Print Reset
NP Annual Report
50 Not-for-Profit Corporation 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
120 S.W. 10th Avenue kssos@ks.gov
Topeka, KS 66612-1594 sos.ks.gov
THIS SPACE FOR OFFICE USE ONLY.

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

2. Name of corporation: Must match name on record with
Kansas Secretary of State.

Street Address (A PO Box is unacceptable)
3. Principal office
address:
Must be a street, rural route, City State Zip Country
or highway. A PO box is
unacceptable.

Month Year
4. Tax closing date:

Name Title
5a. Name, title, and
address of each
officer of corporation: Address

Title and address
required for each City State Zip Country
officer named.
Name Title

Address

City State Zip Country
Do not leave blank.

Name Title

Address

If additional space is needed, City State Zip Country
please provide attachment.

K.S.A. 17-7504 Please continue to next page.
1 / 2 Rev. 6/16/23 tc

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Name Address
5b. Name and address
of each member of
governing body of City State Zip Country
corporation:
Name Address
Leave this question
blank if the governing
body members and City State Zip Country
officers are the same.
Name Address

If additional space is needed, City State Zip Country
please provide attachment.

6a. Does this corporation hold more than 50% equity ownership in any other business entity that is filed with the
Kansas Secretary of State?
o Yes (Complete Question 6b.) o No (Skip to Question 7.)

Business Entity Name Business Entity ID Number (Not FEIN)
6b. Name and ID number
of each business:
Name and ID # should be Business Entity Name Business Entity ID Number (Not FEIN)
provided exactly as filed with
Kansas Secretary of State.
Business Entity Name Business Entity ID Number (Not FEIN)

7. Does this corporation own or lease land in Kansas that is suitable for use in agriculture?
This question does not apply to 1) tracts of land of fewer than 10 acres, 2) contiguous tracts of land that are fewer than 10 acres in aggregate, or 3)
state-assessed railroad operating property.
o Yes (Complete Attachment AG.) o No (Skip to Question 8.)

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 (Required) Title/Position (Required)

X
Name of Signer (printed or typed) Phone Number (Not required)

K.S.A. 17-7504 Please review to ensure completion.
2 / 2 Rev. 6/16/23 tc

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kansas secretary of state Complete this form only if the business entity
Annual Report Agricultural Attachment owns or leases land suitable for agricultural
AG for Forms AR or NP use. All information must be complete or
this document will not be accepted for filing.

Note: This form must be completed if Question 7 on annual report form is answered “yes.”

1. Provide information on each lot, tract or parcel of agricultural land in Kansas owned or leased by corporation.
Location of tract or lot Was this tract Purpose for which land is owned or leased. Indicate for each tract or parcel if the tract is …
acquired
after July 1,
1981?

County Section Township Range Number of acres in tract or lot Yes No Owned by corporation Leased to corporation Leased from corporation If leased from corporation, indicate to whom leased.

A. Total acres owned or operated B. Total acres owned or operated, and irrigated
2. Total agricultural
acres
Must be numeric values.
C. Total acres leased theto corporation D. Total acres leased theto corporation and irrigated
“NA” or “—” is unacceptable.

E. Total acres leased from the corporation F. Total acres leased from the corporation and irrigated

3. Total number of
stockholders

Within Kansas - Agricultural
4. Value and location
of agricultural and
Value Location
nonagricultural assets
owned and controlled Within Kansas - Nonagricultural
by corporation
Include all assets within and Value Location
outside of Kansas.
Outside of Kansas - Agricultural
All lines must be complete.
Value Location
Outside of Kansas - Nonagricultural

Value Location

K.S.A. 17-7504 Please review to ensure completion.
Att. Rev. 6/16/23 tc

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