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   PAUL D. PATE STATEMENT OF CHANGE
OF REGISTERED OFFICE
Secretary of State
AND/OR
State of Iowa REGISTERED AGENT
 
 Pursuant to Iowa law, the undersigned submits this Statement to change the business entity’s registered office and/or registered
        agent in Iowa. Read the instructions on the back ofthis form before completing theinformation  andsigning  below.

      1.The name of the business entity is:

               2.Thestreetaddress of theCURRENT registeredOFFICE, as indicated on the Secretary of State’s records is:

______________________________________________________________________________________
  Street Address  City State           Zip
          The mailing address of theCURRENT registeredOFFICE is:

______________________________________________________________________________________
   Street Address   City State           Zip
         3.Thestreetaddress of theNEW registeredOFFICE is:

______________________________________________________________________________________
   Street Address  City State           Zip
             The mailing address of theNEW registeredOFFICE is:

______________________________________________________________________________________
   Street Address  City State           Zip
              4. The name of theCURRENT registered AGENT as indicated on the Secretary of State’s records is:

______________________________________________________________________________________
  (If more than one AGENT is registered, indicate which one is being replaced.)
     5. The name and email address of the NEW registered AGENT is: 

   _______________________________  ____________________________ 
 Name Email address

        6. If the REGISTERED AGENT has changed, the NEW Registered Agent, or if the new Agent is an entity, an individual 
         representing the Agent entity, must sign here, consenting tothe appointment, or attach awritten consent to this form.

_______________________________________________
  Signature of NEW Registered Agent

7. If the REGISTERED AGENT changes the street address of its business office on this form, the Registered Agent
must sign here indicating that NOTICE of the change has been given to the business entity.

 _______________________________________
Signature of Registered Agent

8.After any/all change(s) are made, the street and mailing addresses of the registered office and of the business
office of the registered agent will be identical.

9.Signature by authorized* representative: _________________________________ Date: _______________
*See instruction #9

PRINTName and Title: _____________________________________________    ( )________ __________
 Name and Title   Telephone Number
635_0119
rev.  /21 2



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INSTRUCTIONS FOR 
STATEMENT OF CHANGE OF REGISTERED OFFICE AND/OR REGISTERED AGENT 

        All Business Entities must submit a Statement of Change form to change the Registered Office and/or 
   Registered Agent in Iowa. 

              It is important to read these INSTRUCTIONS before you fill out the Change form. The numbers on these
       instructions correspond to the numbering on the form. PLEASE PRINT LEGIBLY. 

          1. Print the full name of the Business Entity. Several types   of Business Entities use this same
     form, so include the suffix and proper punctuation.

       2. Print the street and mailing addresses of the CURRENT   Registered Office. 

        3. Print the street and mailing addresses of the NEW   Registered Office. 

        4. Print the full name of the CURRENT Registered Agent.

           5. Print the full name and email address of the NEW Registered Agent.

         6. The NEW Registered Agent, if any, must sign, consenting   to the appointment,   or attach a
    separate written consent   to this form.

              7.   If the Registered Agent changes the street address of its business office,   itsmust NOTIFY the business 
        entity and sign, indicating that NOTICE has been given.

           8. Requires no information. However, it is a required statement, and should be used as a check to verify
               that, after changes, the street address of the registered office and the street address of the business
     office of the registered agent are the same.

         9. Statement   of Change form must be signed a  s follows.It   must also state the date signed, the person’s
      name, and the capacity in which the person signed.

        a. Profit, Nonprofit, and Professional Corporations:*  - No fee required.
             By the chairperson   of the board of directors, the president,   or another officer   of the corporation.

      b. Limited Liability Companies:* - No fee required.
   By an authorized person. 

    c.    Partnerships:* - $5.00 fee required.
                            By two or more partners, a person authorized under Iowa Code ch. 486A, or other law.

      d. Cooperative Associations 497, 498,  499, and 499A:* - No fee required. 
               By the association’s presiding officer of the board of directors, or   the president or   other officer.

         e. Cooperative Corporations (501) and Cooperative Associations (501A):   - No fee required.
     By one of the cooperative’s officers. 
         * If the Business Entity is in the hands of a receiver, trustee, or other court-appointed fiduciary, by that fiduciary.

NOTES: 
        1. One copy is to be delivered or faxed to the Secretary of State for filing.
            2. 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 
635_0119
rev. /2 1 2 






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