Form 635_2001 - Application For Reinstatement

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MATT SCHULTZ
APPLICATION
Secretary of State
FOR
REINSTATEMENT
State of Iowa
TO THE SECRETARY OF STATE OF THE STATE OF IOWA:
Pursuant to Iowa law, the undersigned business entity applies for reinstatement and states:
1.
The name of the business entity on the date of administrative dissolution was:
________________________________________________________________________
2.
The date of the administrative dissolution was: ____________________________________
3.
The ground(s) for dissolution did not exist or has been eliminated.
4.
The business entity applies for reinstatement under the name:
________________________________________________________________________
(Complete only if the name of the business entity at the time of the administrative dissolution is no longer available on the records in this office.)
5.
The federal tax I.D. number of the business entity is: # _______________________________
If the business entity does not have a federal tax I.D. number, state “Not Applicable”. DO NOT report personal social security number.
6.
If the business entity has an Iowa state sales tax permit, the number is: # ___________________
Name of business entity _____________________________________________________
Signature ________________________________________________________________
Title ______________________________________________ Date __________________
The filing fee is $5.00.
635_2001
12/11

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