Statement Of Change Of Registered Office And/or Registered Agent Form - 2011
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1
2STATEMENT OF CHANGE
MATT SCHULTZ
OF REGISTERED OFFICE
Secretary of State
AND/OR REGISTERED AGENT
State of Iowa
(Limited Liability Company - Iowa Code Chap 489)
Pursuant to section 114 of the Iowa Revised Uniform Limited Liability Company Act, the undersigned submits this Statement to
change the limited liability’s registered office and/or registered agent in Iowa. Read the INSTRUCTIONS on the back of this
form before completing the information and signing below.
1.
The NAME of the limited liability company is: ____________________________________________________________ .
2.
The street and mailing address of the CURRENT registered OFFICE as indicated on the Secretary of State’s records is:
__________________________________________________________________________________________________ .
street
city
state
zip
3.
The street and mailing address of the NEW registered OFFICE is:
__________________________________________________________________________________________________ .
street
city
state
zip
4.
The name of the CURRENT REGISTERED AGENT as indicated on the Secretary of State’s records is:
__________________________________________________________________________________________________ .
5.
The name of the NEW REGISTERED AGENT is:__________________________________________________________ .
6.
Signature: ____________________________________________________________________ Date: _______________
*See instruction #6 on back
PRINT Name and Title: ___________________________________________________________________________________
Name and Title
635_08_1
rev. 01/11
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