Form 635_0110a - Application For Certificate Of Authority
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1
2CHESTER J. CULVER
APPLICATION FOR
Secretary of State
CERTIFICATE
State of Iowa
OF AUTHORITY
TO THE SECRETARY OF STATE OF THE STATE OF IOWA:
Pursuant to section 1503 of the Iowa Business Corporation Act, the undersigned corporation applies for a
certificate of authority to transact business in Iowa, and states:
1. The name of the corporation is _____________________________________________________________
1A. [ See note 5 ] The name the corporation will use in Iowa, if different than the legal name of the corporation is
_____________________________________________________________________________________
2. The corporation is incorporated under the laws of the state [or foreign country] of ______________________
3. The date of incorporation of the corporation was ________________________________________________
4. The duration of the corporation is ___________________________________________________________
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 _________________________________________________________________________
Name ________________________________________________________________________________
Address _______________________________________________________________________________
City, State, Zip _________________________________________________________________________
Name ________________________________________________________________________________
Address _______________________________________________________________________________
City, State, Zip _________________________________________________________________________
635_0110A
01/99
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Parent category: Legal