Notice Of Switch Operation - Nebraska Department Of Banking And Finance
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1Notice of Switch Operation
1526 K Street, Suite 300
Nebraska Department of Banking and Finance
PO Box 95006
Lincoln, NE 68509-5006
(402) 471-2171
michael.mcdannel@nebraska.gov
Type of Notice
:
Check all that apply:
Switch had notice on file with Department prior to September 1, 2016.
Intends to continue Nebraska operation on and after September 1, 2016.*
Intends to cease Nebraska operation prior to September 1, 2016.
Cessation Date:
.
Switch intends to begin operation in Nebraska on or after September 1, 2016.** Operational Date:
.
____ Switch intends to cease operation on or after September 1, 2016.
Cessation Date:
.
Notice Details:
Switch Name:
Trade Name/DBA:
Corporate Office Physical Address:
Street:
City:
State:
Zip:
Mailing Address, if Different than Physical Address:
City:
State:
Zip:
Website:
Officer Authorized to Answer Inquiries Related to Switch Operation in Nebraska:
Name:
Title:
Telephone:
Email Address:
Mailing Address, if Different than Switch Mailing Address:
City:
State:
Zip:
*Notice is effective until August 31, 2017. **Minimum 30-day prior notice required.
ATTESTATION:
The information set forth herein is true and correct to the best of my knowledge and belief.
Signature of Corporate Officer:
Date:
Printed Name and Title:
NDBF Use Only: Date Received: ________ By: ________
Form Adopted: 8-2016
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