Application For Amended Certificate Of Authority Foreign Limited Liability Company
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1APPLICATION FOR AMENDED CERTIFICATE OF AUTHORITY
FOREIGN LIMITED LIABILITY COMPANY
Submit in Duplicate
John A. Gale, Secretary of State
Room 1301 State Capitol, P.O. Box 94608
Lincoln, NE 68509
(402) 471-4079
Name of Limited Liability Company_________________________________________
Alternate Name _________________________________________________________
Check the item or items that are being amended and provide the appropriate information:
___Organized under the laws of the State or Jurisdiction of:_______________________
___The name of the organization has been changed to:
_______________________________________________________________________
___ Alternate name changed to:
_______________________________________________________________________
___The address of the principle office has been changed to:
_______________________________________________________________________
Street and mailing address
City
State
Zip
___If required by state or jurisdiction of organization, office maintained in that
jurisdiction has been changed to:
_______________________________________________________________________
Street and mailing address
City
State
Zip
___Nature of the Business or purposes to be conducted in this state has been changed to:
_______________________________________________________________________
___Name and address of registered agent in Nebraska:
Registered Agent Name:___________________________________________________
Registered Agent Address:
______________________________________________________NE_______________
Street Address and post office box number (if any)
City
State
Zip
Effective date if other than the date filed _____________
____________________________________
____________________________________
Signature of Authorized Representative
Printed name Representative
FILING FEE: $15.00 plus $5.00 per additional page
January 2011
Neb. Rev. Stat. 21-159
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