Form 635_2001 - Application For Reinstatement
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1APPLICATION
CHESTER J. CULVER
FOR
Secretary of State
REINSTATEMENT
State of Iowa
TO THE SECRETARY OF STATE OF THE STATE OF IOWA:
Pursuant to Iowa law, the undersigned corporation applies for reinstatement and states:
1.
The name of the corporation 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 corporation applies for reinstatement under the name:
________________________________________________________________________
(Complete only if the name of the corporation 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 corporation is: # _________________________________
6.
If the corporation has an Iowa state sales tax permit, the number is: # _____________________
7.
The filing fee of $5.00 is enclosed.
Name of Corporation _______________________________________________________
Signature ________________________________________________________________
Title ______________________________________________ Date __________________
PLEASE READ INSTRUCTIONS ON THE REVERSE BEFORE COMPLETING
635_2001
06/04
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