Free 635_0988.p65 - Iowa

MICHAEL A. MAURO Secretary of State State of Iowa

STATEMENT OF RESIGNATION OF AGENT
(Limited Partnership - Iowa Code Chap 488)

All items must be completed before the statement of resignation will be considered.

Statement
1

Name of Business Entity: _____________________________________________________________________
2

Principal Office Address: ______________________________________________________________________
3

Designated Office Address: ____________________________________________________________________

4

TO THE SECRETARY OF STATE. Please be advised that notice is hereby given that I, __________________ _________________________________, registered agent appearing on the records of the secretary of state for
5

the business entity, do hereby resign as the registered agent effective _____________________________.

6

Signature of Registered Agent: ___________________________________________________________
7

Date: ___________________________

635_0988 rev. 04/07

INSTRUCTIONS
Read the instructions before completing.

All items must be completed before the application will be considered. Please print or type the information required unless a signature is specified. If you are uncertain about the accuracy of any of the required information, contact the Secretary of State's Office, at (515) 281-5204 for assistance. Each item number below corresponds to the same number as they appear on the Statement.

Statement
1. Insert the complete legal name of the business entity. 2. Insert the address of the business entity's principal place of business. 3. Insert the address of the designated office. 4. Insert your name. 5. State the date on which the resignation shall become effective. 6. Sign the statement. 7. Insert the date the statement was signed.

NOTES:
1. The filing fee is $5.00. Make checks payable to SECRETARY OF STATE. 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, IA 50319 Phone: (515) 281-5204 FAX: (515) 242-5953 or (515) 281-7142 Website: www.sos.state.ia.us