Dw 53 01 is a document that is used in the event of an employee termination. The form provides both the employer and the employee with a detailed outline of what will happen during the termination process. By using Dw 53 01, both parties can be assured that all steps are followed correctly and no surprises arise. This form should be used in any situation where an employee is being terminated, regardless of the reason.
Question | Answer |
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Form Name | Form Dw 53 01 |
Form Length | 2 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 30 sec |
Other names | DW instructions for dw 53 01 form |
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KANSAS SECRETARY OF STATE |
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by Written Consent |
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CONTACT: Kansas Ofice of the Secretary of State |
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Memorial Hall, 1st Floor |
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(785) |
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120 S.W. 10th Avenue |
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kssos@sos.ks.gov |
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Topeka, KS |
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www.sos.ks.gov |
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Above space is for ofice use only. |
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INSTRUCTIONS: All information must be completed or this document will not be accepted for iling. |
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Please read instructions before completing. |
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1. Business entity ID |
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number: |
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This is not the Federal Employer |
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ID Number (FEIN) |
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_______________________________________ |
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2. Name of corporation: |
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Name must match the name on |
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record with the Secretary of State |
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3. Name and mailing |
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address of each oficer: |
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1)______________________________________________________________________________________ |
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Do not leave blank |
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Name |
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If additional space is needed |
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_______________________________________________________________________________________ |
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please provide an attachment |
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2)______________________________________________________________________________________ |
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Name |
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3)_____________________________________________________________________________________ |
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Name |
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4. Name and mailing |
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address of the board of |
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1)______________________________________________________________________________________ |
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directors: |
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Name |
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Do not leave blank |
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If additional space is needed |
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Mailing address |
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2)______________________________________________________________________________________ |
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Name |
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__________________________________________________________________________________________ |
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3) |
_____________________________________________________________________________________ |
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Name |
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____________________________________________________________________________________________________ |
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Rev. 12/27/10 jdr |
Page 1 of 2 |
K.S.A. |
5.All stockholders with voting power do hereby consent to the dissolution of the corporation: Stockholders’ signatures
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____________________________________________ |
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6. Effective date: |
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Upon iling |
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A future effective date must be |
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within 90 days of iling date |
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Future effective date ______________________________ |
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Month |
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Year |
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7. I, _______________________________________, declare under penalty of perjury under the laws of the state of |
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Name of oficer |
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Kansas, that I am an oficer of the |
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of ALL stockholders entitled to vote on the dissolution, that the foregoing is true and correct and that I have remitted |
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the required fee. |
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________________________________________________________ |
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Signature of secretary or other oficer |
Date (month, day, year) |
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Name of signer (printed or typed) |
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iInstructions:
1. If this form is submitted after the close of the entity’s tax year, an annual report and fee must be iled along with or
prior to dissolution. If the entity has forfeited, it must reinstate before dissolution.
2. Submit this form with the $35 filing fee.
STAY
NOTICE: There is a $25 service fee for all checks returned by your inancial institution.
All information must be completed or this document will not be accepted for iling.
Rev. 12/27/10 jdr |
Page 2 of 2 |
K.S.A. |