Form 635-0051 - Application For Reservation Of Name - Ia Secretary Of State
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1CHESTER J. CULVER
APPLICATION FOR
Secretary of State
RESERVATION
State of Iowa
OF NAME
TO THE SECRETARY OF STATE OF THE STATE OF IOWA:
The undersigned applies to reserve exclusive use of a business organization name, pursuant to the (check one)
Iowa Business Corporation Act (profit corporations).
Iowa Nonprofit Corporation Act (nonprofit corporations).
Iowa Limited Partnership Act
Iowa Limited Liability Companies Act
Enter the name here
1. The name to be reserved is ________________________________________________________________
2. The name and address of the applicant is
Enter the name here
Name ________________________________________________________________________________
Enter the street address here
Address _______________________________________________________________________________
Enter the city, state and zip here
City, State, Zip _________________________________________________________________________
Signature ________________________________________________________________________________
Enter your name and title here
Type or print name & title ____________________________________________________________________
Enter today's date here
Date
NOTES:
1. The filing fee is $10.00.
2. Make checks payable to Secretary of State.
3. The information you provide will be open to public inspection under Iowa Code chapter 22.11.
SECRETARY OF STATE
Corporations Division
Lucas Building, 1st Floor
Des Moines, Iowa 50319
Phone: 515/281-5204
635-0051
FAX: 515/242-5953
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