You must submit the following attachments via email to firstname.lastname@example.org with “PEO” in the subject line:
ATTESTATION OF SUBMITTER:
Name of Person Submitting Application:
By checking this box, I attest and affirm that I am authorized to submit this application on behalf of the applicant named herein, and that the information included is true, correct and complete to the best of my knowledge and belief. I understand that knowingly providing false or fraudulent information or knowingly make a material misrepresentation in connection with this application or any information or reports required under the Professional Employer Organization Registration Act, K.S.A. 44-1701 et seq., may result, inter alia, in the denial of the application, revocation of registration, or imposition of fines and penalties.
Date of Application: 12/06/2023