Not For Profit Corporation Certificate Of Correction {NCC}

NCC 53-13 CONTACT: KANSAS SECRETARY OF STATE Not-For-Profit Corporation Certificate of Correction Kansas Office of the Secretary of State (785) 296-4564 kssos@sos.ks.gov www.sos.ks.gov Memorial Hall, 1st Floor 120 S.W. 10th Avenue Topeka, KS 66612-1594 Above space is for office use only. i All information must be completed or this document will not be accepted for filing. Please read instructions before completing. INSTRUCTIONS: 1. Business entity ID number: 2. Name of the corporation: This is not the Federal Employer ID Number (FEIN) _______________________________________ Name must match the name on record with the Secretary of State ________________________________________________________________________________________ _______________________________________ 3. State/Country of incorporation: 4. Specify the document and the inaccuracy that is to be corrected: 5. Set forth the portion of the document in its corrected form: 6. I declare under penalty of perjury under the laws of the state of Kansas that the foregoing is true and correct and that I have remitted the required fee. ________________________________________________________ Signature of authorized officer _______________________________________________________ _ Date (month, day, year) ________________________________________________________ Name of signer (printed or typed) i Instructions: 1. Submit this form with the $20 filing fee. STAY UP-TO-DATE ON YOUR ORGANIZATION'S STATUS, ANNUAL REPORT DUE DATE AND CONTACT ADDRESSES BY GOING TO WWW.SOS.KS.GOV. UNDER QUICK LINKS, SELECT SEARCH BUSINESS ENTITY INFORMATION. There is a $25 service fee for all checks returned by your financial institution. All information must be completed or this document will not be accepted for filing. NOTICE: Rev. 12/27/10 jdr Page 1 of 1 K.S.A. 17-6003 American LegalNet, Inc. www.FormsWorkFlow.com