Form 635_0109 - Application For Certificate Of Authority (Cooperative) Page 2
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1
2Name
Position(s):
Address
City, State, Zip
Name
Position(s):
Address
City, State, Zip
[Please attach additional pages as necessary]
A certificate of existence, or a document of similar import, duly authenticated within 90
9.
days prior to the date of this application, by the secretary of state or other official having
custody of corporate records in the state or country of incorporation, accompanies this
application.
10. Signature
Type or print name and title
NOTES:
1. The filing fee is $100.00. Make checks payable to SECRETARY OF STATE.
2. A certificate of existence, or a document of similar import, duly authenticated within 90 days prior to the date
of this application, by the secretary of state or other official having custody of corporate records in the state or
country of incorporation, must accompany this application.
3. The document is to be signed by the chairperson of the board, the president, or other officer of the corpora-
tion. If directors have not been selected, the document is to be signed by an incorporator. If the corporation
is in the hands of a court appointed fiduciary, the document is to be signed by the fiduciary. A copy of a
signature is acceptable for filing. Verification is not required.
4. One copy of the document is to be delivered to the Secretary of State for filing.
5. The effective time and date of the document is the later of the following:
a. the time of filing on the date it is filed;
b. the time specified in the document on the date it is filed;
c. the time and date specified in the document, not later than 90 days after the date it is filed.
6. If the name of the cooperative association does not satisfy the requirements of Iowa Code section 499.40(1),
the cooperative may do either of the following in applying for a certificate of authority:
a. add the word cooperative to its corporate name for use in Iowa:
or
b. use a fictitious name to transact business in Iowa if the cooperative association’s real name
is unavailable and the cooperative association delivers to the secretary of state for filing a
copy of the resolution of its board of directors, certified by its secretary, adopting the fictitious
name.
7. 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) 242-5953
Website: sos.iowa.gov
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