Application For Electronic Access Of Records For Limited Liability Companies - 2007 Page 2

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MANAGERS OF THE LIMITED LIABILITY COMPANY
This Section Must be Completed. List all managers of the limited liability company who are
required by Nebraska law to be licensed or certified to perform the professional services for
which the limited liability company was organized. (use additional sheets if needed)
_____________________________________
____________________________________
Full Name & License #
Residence Street Address, City, State, Zip
_____________________________________
____________________________________
Full Name & License #
Residence Street Address, City, State, Zip
_____________________________________
____________________________________
Full Name & License #
Residence Street Address, City, State, Zip
_____________________________________
____________________________________
Full Name & License #
Residence Street Address, City, State, Zip
_____________________________________
____________________________________
Full Name & License #
Residence Street Address, City, State, Zip
_____________________________________
____________________________________
Full Name & License #
Residence Street Address, City, State, Zip
PROFESSIONAL EMPLOYEES OF THE LIMITED LIABILITY COMPANY
This Section Must be Completed. List all professional employees of the limited liability
company who are required by Nebraska law to be licensed or certified to perform the
professional services for which the limited liability company was organized. (use additional
sheets if needed)
_____________________________________
____________________________________
Full Name & License #
Residence Street Address, City, State, Zip
_____________________________________
____________________________________
Full Name & License #
Residence Street Address, City, State, Zip
_____________________________________
____________________________________
Full Name & License #
Residence Street Address, City, State, Zip
_____________________________________
____________________________________
Full Name & License #
Residence Street Address, City, State, Zip
_____________________________________
____________________________________
Full Name & License #
Residence Street Address, City, State, Zip
_____________________________________
____________________________________
Full Name & License #
Residence Street Address, City, State, Zip
_____________________________________
____________________________________
or
Signature of Member
Signature of Manager
________________________Date
/
/
______________________Date
/
/
or
Printed Name of Member
Printed Name of Manager

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