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Please
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kansas secretary of state Themust be complete and following form
accompanied by the correct filing fee or the
AR For-Profit Corporation document will not be accepted for filing.
50 Annual Report

Save time and money by filing your forms online
at sos.ks.gov. There, you can also stay up-to-
GENERAL FILING 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.

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

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

Domestic and foreign Use this form to file for both domestic or foreign entities.

Public information All documents filed with our office are available to the public and may be view 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. 17-7503, 17-7505 Please proceed to form.
Inst. Rev. 02/08/23 tc

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Please
Do NotStaple
kansas secretary of state Print Reset
AR For-Profit Corporation
50 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
THIS SPACE FOR OFFICE USE ONLY.

1. Business entity ID/file This is not the Federal Employer ID
number Number (FEIN).

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

Street Address
3. Principal office address
Must be a street, rural route
or highway. A P.O. box is City State Zip Country
unacceptable.

Month Year
4. Tax closing date

Name Title
5a. Name, title, and
address of each
officer of corporation Address
If additional space is needed,
please provide attachment.
City State Zip Country
Do not leave blank.
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. 17-7503, 17-7505 Please continue to next page.
1 / 2 Rev. 02/08/23 tc

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

Name Address

City State Zip Country

6. Total number of shares of capital stock issued

7. What is the nature and kind of business in which corporation is engaged?

8a. 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 8b.) o No (Skip to Question 9.)

Business Entity Name Business Entity ID Number (Not FEIN)
8b. 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)

9. 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 10.)

10. I declare under penalty of perjury pursuant to the laws of the state of Kansas that the foregoing is true and
correct.
Signature (Required) Title/Position (Required)

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

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. 17-7503, 17-7505 Please review to ensure completion.
2 / 2 Rev. 02/08/23 tc

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kansas secretary of state Completeonly if thethisbusinessform 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 9 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. Totalto D. Totalto and irrigated acresacresleased leased thethecorporationcorporation
“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. 17-7503, 17-7505 Please review to ensure completion.
Att. Rev. 02/08/23 tc

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