KANSAS SECRETARY OF STATE en-US en-USen-US53-08en-USen-USK.S.A. 17-76,146en-USRev. 5/2/19 tcen-USAll information on this form en-USen-USen-US, accompanied by en-USen-USen-US or the en-USdocument will en-USen-US be accepted for filing. en-USen-USen-USen-USen-US available at the time of reinstatement, you may change the entity name on the reinstatement en-USform by the following method:en-USOn en-USen-USen-US Example: en-USen-USen-USen-USen-US$35en-US. An en-US$85en-US penalty fee also applies if the reason for forfeiture is failen-US-en-USen-USen-USen-USPlease submit payment by check, money order, or credit card. Checks and money orders need to be en-USmade payable to the Secretary of State. Forms received without the appropriate fee will not be accepted en-USen-USto your check or money order. If paying by credit card, annual report fees will be charged to the card.) en-USen-US en-USen-USen-USVisa, MasterCard, Discover, and American Express are accepted. To use a credit card, please provide en-USthe following information:en-USen-USen-USen-USen-USen-USen-USen-USen-USen-USthe same time. Please make sure all documents, fees and/or taxes are mailed in the en-USen-US.en-USen-USen-USen-USen-USen-USname, daytime phone number, credit card number, credit card expiration date and billing zip code.en-USFax documents and payment information to en-USen-US. Faxed documents will en-USen-USen-US-en-USen-USen-USen-USPlease do not send duplicate copies of your document. The original is processed, and returned to you by en-USmail.en-USen-USen-USen-USen-USen-USen-USen-USen-USen-USwithout cost. Please consider this when providing information on our forms. Instructions and payment en-USinformation are not public information and are shredded after use.en-USGENERAL FILING en-USINSTRUCTIONS en-US en-US American LegalNet, Inc. www.FormsWorkFlow.com en-USen-USen-USen-USannual reports.en-USen-USen-USen-US þ en-USen-USen-USen-US þ $2 for every $1,000 of net worth en-US þ $55 en-US þ $5015 en-USen-USen-USen-US þ $1 for every $1,000 of net worth en-US þ $35 en-US þ $2515 KANSAS SECRETARY OF STATE en-USen-USINSTRUCTIONS FOR en-USANNUAL REPORTS en-USen-US53-08en-USen-USK.S.A. 17-76,146en-USRev. 5/2/19 tc en-US en-US American LegalNet, Inc. www.FormsWorkFlow.com en-US þ en-USen-USNot Federal Employer ID en-US þ en-USMust match name on record en-US en-USwith Secretary of State. þ en-USen-USen-USen-USMust be a Kansas street en-USaddress. A P.O. Box or Rural en-USRoute/Box is unacceptable.en-USNameen-USStreet Addressen-USCityen-USStateen-USen-USZip þ en-USAddress will be used to send en-USen-USen-USAttention Nameen-USAddressen-USCityen-USStateen-USZipen-USCountryen-US þ en-USen-USen-USen-US þ en-USen-USen-US þ en-USen-USSignature of Authorized Personen-USen-USen-USK.S.A. 17-76,146en-USRev. 5/2/19 tc KANSAS SECRETARY OF STATE en-US en-USen-US53-08 en-US en-USen-USTHIS SPACE FOR OFFICE USE ONLY. þ þ 120 S.W. 10th Avenue þ kssos@ks.gov Topeka, KS 66612-1594 þ https://sos.kansas.gov American LegalNet, Inc. www.FormsWorkFlow.com