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          kansas secretary of state                              The following form must be complete and 
                                                                 accompanied by the correct filing fee or the 
          Limited Liability Company 
  CT                                                             document will not be accepted for filing.
  53-05   Certificate of Correction 
          Instructions

Kansas Office of the Secretary of State:                         Save time and money by filing your forms 
                                                                 online at www.sos.ks.gov. There, you can 
Memorial Hall, 1st Floor (785) 296-4564                          also stay up-to-date on your organization’s 
120 S.W. 10th Avenue     kssos@sos.ks.gov                        status, annual report due date, and contact 
Topeka, KS 66612-1594    www.sos.ks.gov                          addresses.

o Filing fee             The filing fee for this document is $35.

o 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.

      K.S.A. 17-7683                                                           Please proceed to form.
Inst. Rev.  /1 /15 tc8 3



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                                                 Print                                Reset
          kansas secretary of state   
          Limited Liability Company                                                                         
   CT                                            Please complete the form, print, sign and mail to the 
   53-05  Certificate of Correction              Kansas Secretary of State with the filing fee.  Selecting 
                                                 'Print' will print the form and 'Reset' will clear the entire 
                                                             form.
Kansas Office of the Secretary of State:

Memorial Hall, 1st Floor         (785) 296-4564
120 S.W. 10th Avenue             kssos@sos.ks.gov
Topeka, KS 66612-1594            www.sos.ks.gov        THIS SPACE FOR OFFICE USE ONLY.

This form must be complete and accompanied by the correct filing fee or the document will not be accepted for filing.

1.  Business entity ID
    number
    Not Federal Employer ID
    Number (FEIN).

2.  Name of limited
    liability company
    Must match name on record
    with Secretary of State.

3.  State of incorporation

4.  Specify the document
    and the inaccuracy
    that is to be corrected:

5.  Set forth the portion
    of the document in its
    corrected form:

6.  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                         Month      Day                 Year
X
Name of Signer (printed or typed)

      K.S.A. 17-7683                                   Please review to ensure completion.
1 / 1 Rev.  /1 /15 tc8 3






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