Form 635_0114 - Application For Amended Certificate Of Authority - 2011

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MATT SCHULTZ
APPLICATION FOR
Secretary of State
AMENDED CERTIFICATE
State of Iowa
OF AUTHORITY
TO THE SECRETARY OF STATE OF THE STATE OF IOWA:
Pursuant to section 1504 of the Iowa Business Corporation Act, the undersigned corporation applies for an
amended certificate of authority to transact business in Iowa, and states:
1. The name of the corporation is _____________________________________________________________
and the name the corporation uses in Iowa if different than its real name is
_____________________________________________________________________________________
The corporate name has been changed to ____________________________________________________
2. The state [or foreign country] of incorporation on the records of the Secretary of State of Iowa is
_____________________________________________________________________________________
The state [or foreign country] of incorporation has been changed to _________________________________
3. The duration of the corporation on the records of the Secretary of State of Iowa is ______________________
The duration has been changed to __________________________________________________________
4. The date of incorporation of the corporation was ________________________________________________
5. The street address of its principal office is
address _______________________________________________________________________________
city, state, zip __________________________________________________________________________
6. The street address of its registered office in Iowa and the name of its registered agent at that office:
name _________________________________________________________________________________
address _______________________________________________________________________________
city, state, zip __________________________________________________________________________
7. The names and business addresses of its current directors and officers:
name _________________________________________________________________________________
address _______________________________________________________________________________
city, state, zip __________________________________________________________________________
635_0114
01/11

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