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Please
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kansas secretary of state The following form must be complete and
Kansas Professional Corporation the correct filing fee or the
accompanied by
PA Annual Report not be accepted for filing.
document will

Save time and money by filing your annual
report online at sos.ks.gov. There, you can also
GENERAL FILING stay up-to-date on your organization’s status,
annual report due date, and contact addresses.
INSTRUCTIONS

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.

Payment 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.

Due date The annual report shall be filed at the time prescribed by law for filing the annual Kansas tax return.

Click HERE or go to https://www.kansas.gov/bess to search for the entity and view the entity’s annual
report due dates.

Forfeiture date 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.

Amending annual reports If you wish to correct information that was erroneously provided on a previously filed annual report, file a
completed Corrected Document form COR with a complete and correct new Annual Report form PA and
submit with a $55 filing fee.

Additional information If additional space is needed, please provide an attachment.

Public Information All documents filed with our office are available to the public and may be viewed online at www.sos.ks.gov
without cost. Please consider this when providing information on our forms. Instructions and payment
information are not public information and are shredded after use.

K.S.A. 17-2718 Please proceed to form.
Inst. Rev. 02/08/23 tc

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Please
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kansas secretary of state
Kansas Professional Corporation
PA Annual Report 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 50
THIS SPACE FOR OFFICE USE ONLY.

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

2. Name of corporation
Must match name on record
with Kansas Secretary of State.
(Required)

3. Tax closing date Month Year

4. The amount of
memberships/shares of
capital stock issued

5a. Name, title, and address Name Title
of each officer of
corporation
Address
If additional space is needed,
please provide attachment.
Do not leave blank. City State Zip Country
Title and Address required for
each officer named.
Name Title

Address

City State Zip Country

Name Title

Address

City State Zip Country

K.S.A. 17-2718 Please continue to next page.
1 / 2 Rev. 02/08/23 tc

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5b. Name and address of Name Address
each of the directors/
members of the
City State Zip Country
governing body
If additional space is needed,
please provide attachment. Name Address
Leave this question blank if
the directors/members of the
governing body and officers are City State Zip Country
the same.

5c. Name and address Name Address
of each shareholder/
member
City State Zip Country
If additional space is needed,
please provide attachment.
Leave this question blank if the Name Address
shareholders/members and
officers are the same.
City State Zip Country

6. Is each officer, director/member of the governing body, and shareholder/member a qualified person as defined by
K.S.A. 17-2707 by the tax closing date?
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).

o Yes (Complete 8, if applicable.) o No (Complete 7 and 8, do not leave blank.)

7. List each of the officers, Name Name
directors/members of
the governing body, and
Name Name
shareholders/members
who are not qualified as
defined by statute. Name Name

8. For the tax period this Date Name
annual report covers,
list the dates that any
shares/memberships Date Name
of the corporation
were no longer owned
by a qualified person
Date Name
and the names of the
shareholders/members.

9. 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. 17-2718 Please review to ensure completion.
2 / 2 Rev. 02/08/23 tc

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