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Application For Amended Certificate Of Authority (Foreign Corp) Form. This is a Nebraska form and can be use in Corporation Secretary Of State.
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APPLICATION FOR AMENDED
CERTIFICATE OF AUTHORITY
LIMITED LIABILITY COMPANY
(FOREIGN)
Submit in Duplicate
John A. Gale, Secretary of State
Room 1301 State Capitol, P.O. Box 94608
Lincoln, NE 68509
(402) 471-4079
http://www.sos.state.ne.us
Name of Limited Liability Company_________________________________________
______________________________________________________________________
Organized under the laws of the State of ____________________________________
Date original certificate of authority was filed in Nebraska ______________________
The name of the organization has been changed to:
The address of the principle office has been changed to:
Nature of the Business or purposes to be conducted or promoted in this state:
________________________________________________________________________
Name and address of registered agent in Nebraska:
Registered Agent Name:___________________________________________________
Address: _____________________________________________NE_______________
Street Address and post office box number (if any)
City
Zip
____________________________________
__________________________________
Signature of Authorized Representative
Printed name Representative
FILING FEE: $15.00
Revised 7/18/08
Neb. Rev. Stat. 21-2641
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