Individual Application For Registration Of Trade Name Form - Nebraska Secretary Of State
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1INDIVIDUAL APPLICATION FOR
REGISTRATION OF TRADE NAME
John A. Gale, Secretary of State
Room 1305 State Capitol, P.O. Box 94608
Lincoln, NE 68509
(402) 471-4079
Submit in Duplicate
PUBLICATION REQUIREMENT: Neb. Rev. Stat. §87-219 "Every duplicate of the registration of a trade
name shall be published by the applicant once in a newspaper of general circulation published in the city or village
where the business is to be located, or, if there is no newspaper in the city or village, in some newspaper of
general circulation in the county. Proof of such publication shall be filed in the office of the Secretary of State
and with the County Clerk of the county where the principal office is located, within thirty days from the date
of registration with the Secretary of State. If proof of publication is not filed with the Secretary of State and
the County Clerk within the thirty days, the registration shall be cancelled by the Secretary of State."
Trade Name____________________________________________________________________
Applicant_______________________________________________________________________
Address_______________________________________________________________________
street address
city
zip
Date of first use of name in Nebraska_______________________________________________
General nature of business _______________________________________________________
_____________________________________________________________________________
State of ____________________
County of __________________
_______________________________ being duly sworn on oath deposes and says that I am the
applicant and I have read and know the contents of said statement, and believe the facts stated herein to
be true and correct.
____________________________________
Signature of Applicant
Subscribed and sworn to before me this _______ day of ____________________, 20_____
seal
____________________________________
Notary Public
Please Note: Registration of a tradename with the State of Nebraska does not guarantee that a similar name
has not been registered nationally with the U.S. Patent and Trademark Office. To check national availability
please call: 800-786-9199 or go to:
FILING FEE: $100.00
Registration Expires 10 years from date of filing
Revised 1/23/2001
Neb. Rev. Stat. §87-210 & 87-219
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