Form Dw 53 01 PDF Details

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.

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Form NameForm Dw 53 01
Form Length2 pages
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Avg. time to fill out30 sec
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DW

 

KANSAS SECRETARY OF STATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For-Proit Corporation Dissolution

 

 

 

 

 

 

53-01

 

by Written Consent

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CONTACT: Kansas Ofice 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

 

 

Above space is for ofice use only.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

i

INSTRUCTIONS: All information must be completed or this document will not be accepted for iling.

 

 

 

Please read instructions before completing.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1. Business entity ID

 

 

 

 

 

 

 

 

 

number:

 

 

 

 

 

 

 

 

 

 

 

 

This is not the Federal Employer

 

 

 

 

 

 

 

 

 

ID Number (FEIN)

 

 

 

_______________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2. Name of corporation:

 

 

 

 

 

 

 

 

 

Name must match the name on

 

 

 

 

 

 

 

 

 

record with the Secretary of State

 

________________________________________________________________________________________

 

 

 

 

 

 

 

 

 

 

3. Name and mailing

 

 

 

 

 

 

 

 

 

address of each oficer:

 

1)______________________________________________________________________________________

Do not leave blank

 

 

 

 

Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If additional space is needed

 

_______________________________________________________________________________________

please provide an attachment

 

 

Mailing address

City

State

Zip

Country

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2)______________________________________________________________________________________

 

 

 

 

 

 

 

 

Name

 

 

 

 

 

 

 

 

 

 

 

 

__________________________________________________________________________________________

 

 

 

 

 

 

 

 

Mailing address

City

State

Zip

Country

 

 

 

 

 

 

 

3)_____________________________________________________________________________________

 

 

 

 

 

 

 

 

Name

 

 

 

 

 

 

 

 

 

 

 

 

____________________________________________________________________________________________________

 

 

 

 

 

 

 

 

Mailing address

City

State

Zip

Country

 

 

 

 

 

 

 

 

 

 

4. Name and mailing

 

 

 

 

 

 

 

 

 

address of the board of

 

1)______________________________________________________________________________________

directors:

 

 

 

 

 

Name

 

 

 

 

 

Do not leave blank

 

 

 

 

 

 

 

 

 

 

 

If additional space is needed

 

_______________________________________________________________________________________

 

 

Mailing address

City

State

Zip

Country

please provide an attachment

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2)______________________________________________________________________________________

 

 

 

 

 

 

 

 

Name

 

 

 

 

 

 

 

 

 

 

 

 

__________________________________________________________________________________________

 

 

 

 

 

 

 

 

Mailing address

City

State

Zip

Country

 

 

 

 

 

 

 

3)

_____________________________________________________________________________________

 

 

 

 

 

 

 

Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

____________________________________________________________________________________________________

 

 

 

 

 

 

 

 

Mailing address

City

State

Zip

Country

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Rev. 12/27/10 jdr

Page 1 of 2

K.S.A. 17-6804

5.All stockholders with voting power do hereby consent to the dissolution of the corporation: Stockholders’ signatures

____________________________________________

_______________________________________________

____________________________________________

_______________________________________________

____________________________________________

_______________________________________________

____________________________________________

_______________________________________________

____________________________________________

_______________________________________________

 

 

 

 

 

6. Effective date:

 

Upon iling

 

 

A future effective date must be

 

 

 

 

within 90 days of iling date

 

Future effective date ______________________________

 

 

 

 

Month

Day

Year

 

 

 

 

 

7. I, _______________________________________, declare under penalty of perjury under the laws of the state of

Name of oficer

 

 

Kansas, that I am an oficer of the above-named corporation, that the above consent has been signed by or on behalf

of ALL stockholders entitled to vote on the dissolution, that the foregoing is true and correct and that I have remitted

the required fee.

 

 

 

________________________________________________________

________________________________________________________

Signature of secretary or other oficer

Date (month, day, year)

________________________________________________________

 

 

Name of signer (printed or typed)

 

 

 

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 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.

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. 17-6804