Kansas Ownership Change Form Ksrevenuegov

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Kansas ownership change form ksrevenuegov

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Summary

KANSAS OWNERSHIP CHANGE FORM
RCN - FOR OFFICE USE ONLY
Name of business: _____________________________________________________ EIN: ___ ___ __ ___ ___ ___ ___ ___ ___
Complete the following information so your customer profile can be maintained with the most current information. You may
copy this form if more space is needed. Important—If a business fails to report or pay appropriate state taxes, any individual
who is responsible for the tax authorizes the Secretary of Revenue to research the credit history of the business or that
individual

Check the appropriate box: ˆ Adding a name ˆ Removing a name
__________________________________________________ _______________________________________________
Printed full proper name of Owner, Partner, or Corporate Officer Signature of Owner, Partner, or Corporate Officer
SSN / EIN (Check one) ____________________________________ Title ____________________________________________
Home address (street, city, state, zip code) ___________________________________________________________________________
Home phone _____________________ Email ___________________________________ Percent of Ownership ______ %
Do or did you have control or authority over how business funds or assets are spent? ˆ Yes ˆ No
Date you became the owner, partner, corporate officer or LLC member; or the effective date to remove your name as the owner,
partner, corporate officer or LLC member of this business. Month ________ Day ________ Year ________
Check the appropriate box: ˆ Adding a name ˆ Removing a name
__________________________________________________ _______________________________________________
Printed full proper name of Owner, Partner, or Corporate Officer Signature of Owner, Partner, or Corporate Officer
SSN / EIN (Check one) ____________________________________ Title ____________________________________________
Home address (street, city, state, zip code) ___________________________________________________________________________
Home phone _____________________ Email ___________________________________ Percent of Ownership ______ %
Do or did you have control or authority over how business funds or assets are spent? ˆ Yes ˆ No
Date you became the owner, partner, corporate officer or LLC member; or the effective date to remove your name as the owner,
partner, corporate officer or LLC member of this business. Month ________ Day ________ Year ________
Check the appropriate box: ˆ Adding a name ˆ Removing a name
__________________________________________________ _______________________________________________
Printed full proper name of Owner, Partner, or Corporate Officer Signature of Owner, Partner, or Corporate Officer
SSN / EIN (Check one) ____________________________________ Title ____________________________________________
Home address (street, city, state, zip code) ___________________________________________________________________________
Home phone _____________________ Email ___________________________________ Percent of Ownership ______ %
Do or did you have control or authority over how business funds or assets are spent? ˆ Yes ˆ No
Date you became the owner, partner, corporate officer or LLC member; or the effective date to remove your name as the owner,
partner, corporate officer or LLC member of this business. Month ________ Day ________ Year ________
Send this form and any payments to: Kansas Department of Revenue, PO Box 3506, Topeka KS 66625-3506
CR-18 (Rev. 8-19)
or FAX to 785-291-3614. For assistance call 785-368-8222

Date you became the owner, partner, corporate officer or LLC member; or the effective date to remove your name as the owner, partner, corporate officer or LLC member of this business. Month _____ Day _____ Year _____ CR-18 (Rev. 8-19) Send this form and any payments to: Kansas Department of Revenue, PO Box 3506, Topeka KS 66625-3506. or

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