Form 635_0106 - Application For Certificate Of Authority - Nonprofit

Form 635_0106 - Application For Certificate Of Authority - Nonprofit - 2015

PAUL D. PATE

APPLICATION FOR

Secretary of State

CERTIFICATE OF AUTHORITY

State of Iowa

(NONPROFIT)

TO THE SECRETARY OF STATE OF THE STATE OF IOWA:

Pursuant to the Revised Iowa Nonprofit Corporation Act, the undersigned corporation applies for a certificate of

authority to transact business in Iowa, and states:

1. The name of the corporation is:

1A. [See Note 6] The name the corporation will use in Iowa, if different than the legal name of the corporation is:

2. The corporation is incorporated under the laws of the state [or foreign country] of :

3. The date of incorporation of the corporation was:

4. The duration of the corporation is:

5. The street address of its principal office is:

Address

City, State, Zip

6. The street address of its registered office in Iowa and the name of its registered agent at that office

Name

Address

City, State, Zip

7. Check one:

The corporation has members.

The corporation has no members.

8. The names and usual business or home addresses of its current directors and officers:

Name

Address

City, State, Zip

Name

Address

City, State, Zip

635_0106

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Form 635_0106 - Application For Certificate Of Authority - Nonprofit - 2015