AMENDED CERTIFICATE OF ORGANIZATION
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
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Name of Limited Liability Company
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Date Certificate of Organization was filed
Please mark the changes this amendment makes to the certificate as most recently
amended or restated and provide the appropriate changes.
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Name of Limited Liability Company
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Professional Service being rendered by the Limited Liability Company
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Street and mailing address of the Designated Office
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Name of Registered Agent
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Street, mailing address and post office box (if any) of Registered Agent
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Any other changes to the certificate of organization
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(attach additional pages if needed)
Effective date if other than the date filed _____________
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Signature of Authorized Representative
Printed Name of Authorized Representative
Date
FILING FEE: $15.00 plus $5.00 per additional page
Revised 10/12/11
Neb. Rev. Stat. 21-
118