800 S.W. Jackson Street, Suite 1408 Topeka, Kansas 66612-2214 Phone: 785-235-1188 Fax: 785-235-2544 Email: phansen-nagy@kapa-krmca.org 2019 Membership Investment Report Contact Name: Company: Email: Total Tons Produced: Fields in yellow are required! Requesting Quarterly Dues billing: No Yes Finish and e-mail me the completed MIR form Dues are payable annually in advance and are based on your aggregate production during the preceding calendar year (2018). Total Tons Produced Here ------------------------------> Production Level Tons Produced Rate Amount 0-100,000 Minimum 776.00 100,000-500,000 0.0064 500,000-750,000 0.0040 750,000-1,000,000 0.0036 1,000,000 + 0.0027 Total Investment Information submitted remains confidential and is only available to staff.