o
Filing fee The ling fee for the annual report is $55. If you are ling 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.
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 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
Due date The annual report shall be led at the time prescribed by law for ling the annual Kansas tax
return.
o
Forfeiture date If the annual report is not led 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 le the annual report and pay the annual report fee
on or before the forfeiture date to avoid forfeiture.
o
Amending annual
reports
If you wish to correct information that was erroneously provided on a previously led annual
report, le a completed Corrected Document form COR, with a complete and correct new
Annual Report form AR and submit with a $55 ling fee.
o
Additional information If additional space is needed, please provide an attachment.
o
Domestic and foreign Use this form to le for both domestic or foreign entities.
kansas secretary of state
For-Prot Corporation
Annual Report
AR
50
Inst.
K.S.A. 17-7503, 17-7505
Rev. 9/19/18 tc
Please proceed to form.
The following form must be complete and
accompanied by the correct filing fee or the
document will not be accepted for filing.
Save time and money by filing your forms
online at www.sos.ks.gov. There, you can
also stay up-to-date on your organization’s
status, annual report due date, and contact
addresses.
Please
Do Not
Staple
GENERAL FILING
INSTRUCTIONS
1. Business entity ID #
This is not the Federal Employer ID
Number (FEIN).
2. Name of corporation
(17-7503(a)(1), 17-7505(a)(1))
Must match name on record with
Kansas Secretary of State.
3. Principal ofce address
Must be a street or highway. A
P.O. box is unacceptable.
(17-7503(a)(2), 17-7505(a)(2))
Street Address
City State Zip Country
4. Tax closing date
Month Year
5. State of incorporation
(17-7505(a)(1))
6a. Name, title, and
address of each
ofcer of corporation
If additional space is needed,
please provide attachment.
Do not leave blank.
(17-7503(a)(3), 17-7505(a)(3))
Name Title
Address
City State Zip Country
Name Title
Address
City State Zip Country
Name Title
Address
City State Zip Country
THIS SPACE FOR OFFICE USE ONLY.
kansas secretary of state
For-Prot Corporation
Annual Report
Memorial Hall, 1st Floor (785) 296-4564
120 S.W. 10th Avenue kssos@ks.gov
Topeka, KS 66612-1594 www.sos.ks.gov
1 / 2
K.S.A. 17-7503, 17-7505
Rev. 9/19/18 tc
Please continue to next page.
AR
50
Please
Do Not
Staple
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.
6b. Name and address
of each director of
corporation
If additional space is needed,
please provide attachment.
Leave this question blank if
the directors and ofcers are
the same.
(17-7503(a)(3), 17-7505(a)(3))
Name Address
City State Zip Country
Name Address
City State Zip Country
Name Address
City State Zip Country
7. Federal Employer Identication Number (FEIN)
(Not required)
8. Total number of shares of capital stock issued
(17-7503(a)(4), 17-7505(a)(4))
9. What is the nature and kind of business in which corporation is engaged?
(17-7503(a)(5), 17-7505(a)(5))
10a. Does this corporation hold more than 50% equity ownership in any other business entity that is led with the
Kansas Secretary of State?
(17-7503(a)(6), 17-7505(a)(6))
o
Yes (Complete Question 10b.)
o
No (Skip to Question 11.)
10b. Name and ID number
of each business
Name and ID # should be
provided exactly as led with
Kansas Secretary of State.
Business Entity Name Business Entity ID Number (Not FEIN)
Business Entity Name Business Entity ID Number (Not FEIN)
Business Entity Name Business Entity ID Number (Not FEIN)
11. Does this corporation own or lease land in Kansas that is suitable for use in agriculture?
(17-7503(b), 17-7505(b))
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 12.)
12. I declare under penalty of perjury pursuant to the laws of the state of Kansas that the foregoing is true and
correct.
(17-7503(c), 17-7505(c))
Signature of Authorized Officer
X
Name of Signer (printed or typed) Title/Position (Required) Phone Number
2 / 2
K.S.A. 17-7503, 17-7505
Rev. 9/19/18 tc
Please review to ensure completion.
kansas secretary of state
Annual Report Agricultural Attachment
for Forms AR or NP
AG
Complete this form only if the business entity
owns or leases land suitable for agricultural
use. All information must be complete or
this document will not be accepted for filing.
Att.
K.S.A. 17-7503, 17-7505
Rev. 9/19/18 tc
2. Total agricultural
acres
Must be numeric values.
“NA” or “—” is unacceptable.
A. Total acres owned or operated
(17-7503(b)(5))
B. Total acres owned or operated, and irrigated
(17-7503(b)(6))
C. Total acres leased to the corporation
(17-7503(b)(5))
D. Total acres leased to the corporation and irrigated
(17-7503(b)(6))
E. Total acres leased from the corporation
(17-7503(b)(5))
F. Total acres leased from the corporation and irrigated
(17-7503(b)(6))
3. Total number of
stockholders
(17-7503(b)(4))
4. Value and location
of agricultural and
nonagricultural assets
owned and controlled
by corporation
Include all assets within and
outside of Kansas.
All lines must be complete.
(17-7503(b)(3))
Within Kansas - Agricultural
Value Location
Within Kansas - Nonagricultural
Value Location
Outside of Kansas - Agricultural
Value Location
Outside of Kansas - Nonagricultural
Value Location
Note: This form must be completed if Question 11 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
(17-7503(b)(1))
Was this tract
acquired
after July 1,
1981?
(17-7503(b)(7))
Purpose for which land is owned or leased.
(17-7503(b)(2))
Indicate for each tract or parcel if the tract is …
(17-7503(b)(5))
County
Section
Township
Range
Number of acres in
tract or lot
Owned by
corporation
Leased to
corporation
Leased from
corporation
If leased from
corporation,
indicate to whom
leased.
Yes
No
Please review to ensure completion.