Amendment Or Correction To Biennial Report Template printable pdf download

Amendment or Correction to

Biennial Report

LIMITED COOPERATIVE ASSOCIATION

John A. Gale, Secretary of State

Room 1301 State Capitol, P. O. Box 94608

Lincoln, NE 68509

(402) 471-4079

1) Name of Limited Cooperative Association (as stated in the articles of organization, or certificate of

authority filed with the Nebraska Secretary of State): __________________________________________

_____________________________________________________________________________________

2) Foreign limited cooperative association ONLY: Alternative Name: ____________________________

____________________________________________________________________________________

3) Year of Biennial Report being corrected

: _______________ - _______________

(found on Report form)

4) Amendment or Correction to the Designated Office:

___________________________________________________________________NE_______________

Street and Mailing Address

City

Zip

5) Amendment or Correction to Name or Address of the Agent for Service of Process in Nebraska

_____________________________________________________________________________________________________

Name of Agent for Service of Process

_________________________________________________________________________NE ________________

Street and Mailing Address of Agent for Service of Process

City

Zip

6) Amendment of Correction to Principal Office:

_________________________________________________________________________NE_________________

Street and Mailing Address

City

Zip

7) Foreign limited cooperative ONLY-Amendment or Correction of the name of the state or other

jurisdiction under whose laws the limited cooperative association was formed: _____________________

_____________________________________________________________________________________________________

Signature of Officer or Authorized Representative Required

plus $5.00 per page for any additional pages

FILING FEE: For Profit $30.00

plus $5.00 per page for any additional pages

Not for profit $10.00

1/1/2008

Neb. Rev. Stat. §

21-2923

Amendment Or Correction To Biennial Report Template