o
Original certicate
of good standing or
existence
The certicate must be issued by the state, country or other jurisdiction where organized
attesting to the fact that such foreign limited liability company is in good standing in such
jurisdiction. The certicate must be issued within 90 days of ling the application.
o
Filing fee The ling fee for this document is $165.
o
Payment Please enclose a check or money order payable to the Secretary of State. Applications
received without the appropriate fee will not be accepted for ling. Please do not send cash.
NOTICE: There is a $25 service fee for all checks returned by your nancial institution. Also,
to expedite processing, please do not use staples on your documents or to attach
checks.
o
Company name The limited liability company name on all documents must be exactly the same as it appears
on the certicate, including punctuation. If the LLC applying for authority has the same name
as an entity already on le, you may do one of the following:
Include a letter of consent from the existing entity to use the name. If the existing entity is
a corporation, the consent must be signed by an authorized ofcer. A consent from
another type of entity must be signed by any authorized person.
Include a letter stating that the LLC will list its home state as a means of identication and
in its advertising in the state of Kansas.
The use of the LLC name is governed by K.S.A. 17-76, 123. You may view statutes at
www.kslegislature.org.
o
Resident agent The resident agent is a person or entity that is authorized to accept service of process
(lawsuits) on behalf of the business entity. This does not necessarily mean that the agent
himself/herself is being sued, but that he/she has the authority and responsibility to accept
service of process on behalf of the business.
o
Registered ofce The registered ofce is the address where the resident agent is located.
o
Mailing address The mailing address is where you would like to receive ofcial mail from the Secretary of
State’s Ofce.
o
Signature The application requires the signature of an authorized ofcer.
NOTICE: If the entity has been doing business in Kansas at least six months prior to ling with
our ofce, you may owe annual reports and/or penalty fee (K.S.A. 17-76, 139)
kansas secretary of state
Foreign Limited Liability
Company Application
Instructions
Kansas Ofce 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
FL
51-10
Inst.
K.S.A. 17-76, 121
Rev. 10/1/15 tc
Please proceed to form.
All information on the application must be
complete and accompanied by the correct
filing fee or the document will not be
accepted for filing.
Stay up-to-date on your organization’s
status, annual report due date and contact
addresses by going to www.sos.ks.gov.
Instructions: All information must be completed or this document will not be accepted for ling.
1. Name of limited
liability company
Must match the name on
record with the home state
2. State/Country of
organization
3. Date of organization
in home state
Month Day Year
4. Began doing business
in Kansas
o
Upon qualication
o
Date
Month Day Year
5. Name of resident
agent and address of
registered ofce in
Kansas
Must be a Kansas street
address. A P.O. Box is
unacceptable.
Name
Street Address
City State
KS
Zip
6. Mailing address
Address will be used to send
ofcial mail from the Secretary
of State’s Ofce.
Attention Name
Address
City State Zip Country
7. Tax closing month
1 / 2
K.S.A. 17-76, 121
Rev. 10/1/15 tc
Please continue to next page.
kansas secretary of state
Foreign Limited Liability
Company Application
Kansas Ofce 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
FL
51-10
A certificate of existence or good standing
from the home Secretary of State must
accompany this application.
THIS SPACE FOR OFFICE USE ONLY.
Print
Reset
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.
8. Full nature and
character of the
business to be
conducted in Kansas
9. If management vests
with members, please
provide the name
and address of each
member.
If management vests
with managers, please
provide the name
and address of each
manager
Do not leave blank. If
additional space is needed
please provide and
attachment.
Name 1
Address
City State Zip Country
Name 2
Address
City State Zip Country
Name 3
Address
City State Zip Country
Name 4
Address
City State Zip Country
10. The limited liability company 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 where there is a proper venue by service of
process on the Secretary of State of the state of Kansas; and the limited liability company 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 members of the foreign limited liability company.
11. I declare under penalty of perjury under the laws of the state of Kansas that the foregoing is true and correct, and
that the company is in good standing in its home state, and I have remitted the required fee.
Signature of Manager or Member Month Day Year
2 / 2
K.S.A. 17-76, 121
Rev. 10/1/15 tc
Please review to ensure completion.