PAUL D. PATE Secretary of State State of Iowa APPLICATION FOR REINSTATEMENT TO THE SECRETARY OF STATE OF THE STATE OF IOWA: Pursuant to Iowa law, the undersigned business entity applies for reinstatement and states: 1. The name of the business entity on the date of administrative dissolution was: 2. 3. 4. The date of the administrative dissolution was: The ground(s) for dissolution did not exist or has been eliminated. The business entity applies for reinstatement under the name: (Complete only if the name of the business entity at the time of the administrative dissolution is no longer available on the records in this office.) 5. The federal tax I.D. number of the business entity is: # If the business entity does not have a federal tax I.D. number, state "Not Applicable". DO NOT report personal social security number. 6. If the business entity has an Iowa state sales tax permit, the number is: # Name of business entity Signature Title Date The filing fee is $5.00. 635_2001 1/15 American LegalNet, Inc. www.FormsWorkFlow.com INSTRUCTIONS NOTES: 1. 2. The filing fee is $5.00. Make checks payable to SECRETARY OF STATE The sales tax permit number is not required, but will expedite the processing of your application for reinstatement. The form should be signed as follows: a. Profit, Nonprofit, and Professional Corporations:* By chairperson of the board of directors, the president, or another officer of the corporation. b. Limited Liability Companies:* By any authorized person. c. 501 Cooperatives:* By an officer of the cooperative. * If the business entity is in the hands of a receiver, trustee, or other court-appointed fiduciary, by that fiduciary. 3. 4. 5. One copy of the document is to be delivered to the Secretary of State for filing. If the business entity was administratively dissolved due to failure to comply with biennial reporting requirements, the business entity must file all delinquent biennial reports and pay all delinquent fees. The biennial reports and fees must accompany the application. If the business entity was administratively dissolved due to failure to maintain a registered agent or registered office, the business entity must name a registered agent and office at the time of filing this application. The statement of change and fees must accompany the application. If the business entity was administratively dissolved due to the expiration of the business entity's duration, the business entity must file articles of amendment or restated articles. The articles of amendment or restated articles and fees must accompany the application. The reinstatement relates back to the effective date of the administrative dissolution. 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: sos.iowa.gov 6. 7. 8. 9. 635_2001 1/15 American LegalNet, Inc. www.FormsWorkFlow.com