APPLICATION FOR 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 An original certificate of good standing from the appropriate authority in the jurisdiction or state under whose laws the limited liability company was organized must be filed with this document. NOTE: A certified copy of the company's articles of organization may not be filed in lieu of a certificate of good standing. Name of Limited Liability Company_________________________________________ _____________________________________________________________________ Address of Principal Business office: _____________________________________________________________________ Street Address City State Zip Organized under the laws of the State of _________________________ Date of Organization _____________________ 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) ____________________________________ Signature of Member or Manager City Zip _________________________________ Printed name of Member or Manger FILING FEE: $120.00 Revised 07/18/08 Neb. Rev. Stat. 21-2638 American LegalNet, Inc. www.FormsWorkflow.com