Form 635_0119 - Statement Of Change Of Registered Office And/or Registered Agent - 2011 Page 2
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1
2INSTRUCTIONS FOR
STATEMENT OF CHANGE OF REGISTERED OFFICE AND/OR REGISTERED AGENT
All Business Entities must submit a Statement of Change form to change the Registered Office and/or
Registered Agent in Iowa.
It is important to read these INSTRUCTIONS before you fill out the Change form. The numbers on these
instructions correspond to the numbering on the form. PLEASE PRINT LEGIBLY.
1.
Print the full name of the Business Entity on line 1. Several types of Business Entities use this same
form, so include the suffix and proper punctuation.
2. & 3. Print the street address, city, state and zip code of the CURRENT and the NEW Registered Office.
4. & 5. Print the full name of the CURRENT and the NEW Registered Agent.
6.
The NEW Registered Agent, if any, must sign line 6, consenting to their appointment, or attach a
separate written consent to this form.
7.
If the Registered Agent changes the street address of their business office, they must NOTIFY the
business entity and sign line 7, indicating that NOTICE has been given.
8.
Line 8 requires no information. However, it is a required statement, and should be used as a check to
verify that, after changes, the street address of the registered office and the street address of the
business office of the registered agent are the same.
9.
Line 9 of the Statement of Change form should be signed as follows. It must also state the date
signed, the person’s name, and the capacity in which the person signed.
a. Profit, Nonprofit, and Professional Corporations:*
By the chairperson of the board of directors, the president, or another officer of the corporation.
b. Limited Liability Companies:*
By an authorized person.
c. Partnerships:*
By two or more partners, a person authorized under Iowa Code ch. 486A, or other law.
d. Cooperative Associations 497 , 498 and 499:*
By the association’s presiding officer of the board of directors, or the president or other officer.
e. Cooperative Corporations (501) and Cooperative Associations (501A):
By one of the cooperative’s officers.
* If the Business Entity is in the hands of a receiver, trustee, or other court-appointed fiduciary, by that fiduciary.
NOTES:
1. There is NO FILING FEE.
2. One copy is to be delivered or faxed to the Secretary of State for filing.
3. The information you provide will be open to public inspection under Iowa Code chapter 22.11.
SECRETARY OF STATE
Business Services Division
Lucas Building, 1st Floor
Des Moines, Iowa 50319
Phone: (515) 281-5204
FAX: (515) 281-7142 or (515) 242-5953
Website:
635_0119
rev. 01/11
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