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                       kansas secretary of state                                    All information on the application for 
                                                                                    registration 
                       Application for Registration of                                           must be complete and 
                                                                                    accompanied by 
            FA         Foreign Covered Entity                                                            the correct filing fee or the 
                                                                                    document will not be accepted for filing.

                       GENERAL FILING 

                       INSTRUCTIONS

n           Filing fee           The filing fee for this document is $115 or $165, depending on the entity type. 

n           Payment              Please submit payment by check, money order, or credit card. Checks and money orders need to be 
                                 made payable to the Secretary of State.  Forms received without the appropriate fee will not be accepted 
                                 for filing. Please do not send cash. 

                                 Visa, MasterCard, Discover, and American Express are accepted. To use a credit card, please provide 
                                 the following information:

                                 Credit card number __________________________________________________________________

                                 Billing zip code _____________________________   Expiration date _________________________

                                 NOTICE:  There is a $25 service fee for all returned checks.

n           Daytime phone and 
            contact person       ___________________________________________________________________________________
n           Fax filing available Documents may be fax filed for a processing fee of $20 in addition to the normal filing fee. Include contact 
                                 name, daytime phone number, credit card number, credit card expiration date and billing zip code. 

                                 Fax documents and payment information to Business Services, 785-296-4570. Faxed documents that are 
                                 without errors and received prior to 4:00 p.m. CT will receive that day’s file date.  Faxed documents received 
                                 after 4:00 pm CT cannot be guaranteed to receive that day’s filing date.

                                 Filed documents will be returned by mail. You may request a file-stamped copy be faxed for an additional $1 
                                 per page. Fax filing does not guarantee same day return faxing.

n           No duplicate copies  Please do not send duplicate copies of documents. The original is processed, file stamped and returned 
                                 by mail to the address provided.

n           No email             Filings are not accepted by email.

n           No filing by phone   No documents or reports can be filed with our office by phone.

n           Public information   All information filed with our office is available to the public, and much of it may be viewed online without 
                                 cost. Please consider this when providing information on our forms.

            K.S.A. 17-7931                                                                               Please proceed to form.
Inst.       Rev. 5/17/21 nw



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            FA                   FA FORM 
            I                    INSTRUCTIONS

Note: Any foreign covered entity (for profit corporation, not for profit corporation, limited liability company, series 
limited liability company, limited partnership, or limited liability partnership) may use this form to apply for authority or 
qualification in Kansas.

Question on Form

1.  Foreign covered entity name  The foreign covered entity name on all documents must be exactly the same as it appears on the 
                                 certificate, including punctuation. If the entity applying for authority has the same name as an entity 
                                 already on file, you may do one of the following:
                                 • Include a letter of consent from the existing entity to use the name.
                                 • Include a letter stating that the foreign covered entity will list its home state as a means of 
                                   identification and in its advertising in the state of Kansas.
                                 The name requirements for foreign covered entities are governed by K.S.A. 17-7933. You may view 
                                 statutes at www.ksrevisor.org.

3.  Date of formation in home    The home state may include this date on the certificate of good standing/existence. Please use the date 
            state                provided by the home state.

4.  Original certificate of good The certificate must be an original. We will accept online certificates with a verification code if the home 
            standing/existence   state offers those. We will not accept screen shots of an entity’s status.
                                 * Click here to see each state/jurisdiction’s certificate and issuing agency.

5.  Date entity began doing      Indicate the date the entity began doing business in Kansas if prior to the filing date. If the entity 
            business in Kansas   began doing business in Kansas more than six months prior to its fiscal year end (question 8), it may 
                                 owe annual reports and fees with the application. If more than two annual reports are due, or if more 
                                 than 7 months and 15 days have passed from the most recent fiscal year end due and the date of the             
                                 application, a penalty fee* of $85 applies to the application fee. All application fees, penalty fees and    
                                 annual report fees may be paid with one check.
                                 Example: An entity with a fiscal year end of December that was doing business in Kansas prior to July 1 
                                 of the previous year would include one annual report and its filing fee with the application.
                                 To determine reports and fees due, see FA-I Annual Report Fee Schedule attachment for for-profit       
                                 entities and not-for-profit corporations.
                                 *Penalty fees do not apply to not-for-profit corporation applications with annual reports due.

6.  Resident agent               The resident agent is a person or an entity registered with the Kansas Secretary of State that is 
                                 authorized to accept service of process (lawsuits) on behalf of the business entity. This does not mean 
                                 the agent is being sued, but that the agent has the authority and responsibility to accept service of     
                                 process on behalf of the business.
     Registered office           The registered office is the Kansas street address where the resident agent is located.

11a.  Series LLCs                This statement applies only if the application is for a series limited liability company.

11b.  LLPs                       This statement applies only if the application is for a limited liability partnership.

12.  Signature                   The signer of the application may be whatever governor (officer, director, authorized person, or partner) 
                                 with authority according to the organic documents of the entity in its home state. There is no need to list 
                                 a title with the signature.

                  K.S.A. 17-7931
Inst.             Rev. 5/17/21 nw



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            FA               ANNUAL REPORT 
            I                FEE SCHEDULE

For-profit entities:
Corporations (use annual report Form AR)
Limited liability companies (use annual report Form LC)
Limited liability partnerships (use annual report Form LLP)
Limited partnerships (use annual report Form LP)
            To determine fees and/or franchise taxes owed, please refer to the chart below for the tax years for which the entity is filing past due 
            annual reports.

            Annual reports with tax year ending DECEMBER 2004 TO PRESENT:

            Franchise tax calculation: N/A

            Minimum amount:            $55 flat filing fee
            Maximum 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.

            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 filed for not-for-profit corporations PRIOR TO 1972.

              K.S.A. 17-7931
Inst.         Rev. 5/17/21 nw



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                        kansas secretary of state                                             Print                                        Reset
                        Application for Registration of                                       Please complete the form, print, sign and mail to the 
            FA          Foreign Covered Entity                                                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.

      All information on the application for registration must be complete and accompanied by the correct filing fee or the document will 
      not be accepted for filing. A certificate of existence or good standing from the home state must accompany the application.

         Choose type of covered          o Corporation for profit                             o Series limited liability company 
            entity:                           (fee $115) 51-03                                      (fee $165) 51-33
                                                                                                    (Complete statement 11a, if applicable)

                                         o Corporation not for profit                         o Limited partnership 
                                              (fee $115) 51-17                                      (fee $165) 51-06

                                         o Limited liability company                          o Limited liability partnership 
                                              (fee $165) 51-10                                      (fee $165) 51-18
                                                                                                    (Statement 11b applies)

      1.  Name of covered entity:
            Must exactly match name on 
            certificate.

      2.  State or foreign country 
            of origin:

                                         Month           Day                             Year
      3.  Date of formation in 
            home state:

      4.  Include a statement (certificate of good standing/existence*) issued within 90 days of the application by the proper 
            officer of the jurisdiction where such foreign entity is organized (usually the Secretary of State or comparable 
            agency) that the entity exists in good standing under the laws of the jurisdiction of its organization.
            * Click here to see each state/jurisdiction’s certificate and issuing agency.

      5.  Date the covered entity        Month           Day                             Year       See FA-I #5 for additional filings and fees that 
            began doing business                                                                    may be due.
            in Kansas if prior to the 
            filing date:

                                         Name
      6.  Name of resident 
            agent and address of 
            registered office in         Street Address
            Kansas:
            Must be a Kansas street 
            address. A P.O. Box or Rural City                                                 State Zip
            Route/Box is unacceptable.
                                                                                              KS

                 K.S.A. 17-7931                                                                     Please continue to next page.
1 / 2            Rev. 5/17/21 nw



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                                   Attention Name
  7.  Mailing address:
  Address will be used to send 
  official mail from the Secretary Address
  of State’s office

                                   City                     State                  Zip   Country

  8.  Fiscal year end:

  9.   Full nature and 
  character of business 
  to be conducted in 
  Kansas:

  10.  The foreign covered entity hereby consents, without power of revocation, that actions may be commenced against 
  it in the proper court of any county in the state of Kansas; and the foreign covered entity stipulates and agrees 
  that such service shall be taken and held in all courts to be valid and binding as if due service had been made 
  upon the authorized persons of the foreign covered entity.

11a. This statement applies to foreign series limited liability companies only, and applies only if the series limited 
  liability company is chosen as type of covered entity.
  The limited liability company is governed by an operating agreement that establishes or provides for the establishment of 
  a series of members, managers, limited liability company interests or assets having separate rights, powers or duties with 
  respect to specified property or obligations of the foreign limited liability company or profits and losses associated with 
  specified property or obligations.

  Check all        The debts, liabilities and obligations incurred, contracted for or otherwise existing with respect to a particular 
  that apply:
                   series, if any, are enforceable against the assets of such series only, and not against the assets of the foreign 
      o            limited liability company generally or any other series thereof.
                   Any of the debts, liabilities, obligations and expenses incurred, contracted for or otherwise existing with respect 
      o            to the foreign limited liability company generally or any other series thereof shall be enforceable against the 
                   assets of such series.

11b. This statement applies to foreign limited liability partnerships only, and applies only if the foreign limited liability 
  partnership is chosen as type of covered entity.
  The above-named partnership elects to be a foreign limited liability partnership.

  12.  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                         Name of Signer (Printed or Typed)

 x

 Please note that information provided on documents filed with the Secretary of State is public record that is subject to 
 public access and disclosure (per K.S.A. 45-215 through K.S.A. 45-223).

      K.S.A. 17-7931                                                                     Please review to ensure completion.
2 / 2 Rev. 5/17/21 nw






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