Form 635_0106 Application for Certificate of Authority (Nonprofit) - Iowa

Form 635_0106 is a Iowa Secretary of State form also known as the "Application For Certificate Of Authority (nonprofit)". The latest edition of the form was released in January 1, 2015 and is available for digital filing.

Download a PDF version of the Form 635_0106 down below or find it on Iowa Secretary of State Forms website.

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PAUL D. PATE
APPLICATION FOR
Secretary of State
CERTIFICATE OF AUTHORITY
State of Iowa
(NONPROFIT)
TO THE SECRETARY OF STATE OF THE STATE OF IOWA:
Pursuant to the Revised Iowa Nonprofit 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 6] 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. Check one:
The corporation has members.
The corporation has no members.
8. The names and usual business or home addresses of its current directors and officers:
Name
Address
City, State, Zip
Name
Address
City, State, Zip
635_0106
1/15
PAUL D. PATE
APPLICATION FOR
Secretary of State
CERTIFICATE OF AUTHORITY
State of Iowa
(NONPROFIT)
TO THE SECRETARY OF STATE OF THE STATE OF IOWA:
Pursuant to the Revised Iowa Nonprofit 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 6] 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. Check one:
The corporation has members.
The corporation has no members.
8. The names and usual business or home addresses of its current directors and officers:
Name
Address
City, State, Zip
Name
Address
City, State, Zip
635_0106
1/15
Name
Address
City, State, Zip
Name
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 $25.00. 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 corporation.
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 corporation does not satisfy the requirements of section 1506 of the Revised Iowa Nonprofit
Corporation Act, the corporation may use a fictitious name to transact business in Iowa if the corporation's real name
is unavailable and the corporation 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, IA 50319
Phone: (515) 281-5204
Fax: (515) 242-5953
Website: s os.iowa.gov

Download Form 635_0106 Application for Certificate of Authority (Nonprofit) - Iowa

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