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PAUL D. PATE Application for
Secretary of State Renewal of Registration
of Corporate Name
State of Iowa
Pursuant to Iowa law, the business entity applies for a renewal of the registration of its name for the calendar
year and states:
1. The name of the business entity is
2. The state or foreign country in which the business entity is incorporated/formed is:
3. The date of its incorporation/formation is
4. A brief description of the nature of the business in which the entity is engaged is:
5. A certificate of existence, or a document of similar import, from the state or country of incorporation/formation
accompanies this application.
Signature Date
Type or print name and title
NOTES:
1. The filing fee is $20.00. Make checks payable to SECRETARY OF STATE
2. The application is to be signed by the chairperson of the board of directors, the president, or another officer of
the corporation. It must also state the person's name and the capacity in which the person signed.
3. One copy of the document is to be delivered to the Secretary of State for filing.
4. The renewal application is to be filed between October 1 and December 31 of the calendar year to which
the renewal applies.
5. The information you provide will be open for public inspection under Iowa Code section 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_0120
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