Application For Certificate Of Authority Limited Liability Company (Foreign)
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1APPLICATION 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
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)
City
Zip
____________________________________
_________________________________
Signature of Member or Manager
Printed name of Member or Manger
FILING FEE: $120.00
Revised 07/18/08
Neb. Rev. Stat. 21-2638
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