Registration Or Renewal Of Corporate Name Foreign Corporations - Nebraska Secretary Of State

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REGISTRATION OR RENEWAL OF CORPORATE NAME
FOREIGN CORPORATIONS
John A. Gale, Secretary of State
Room 1301 State Capitol, P.O. Box 94608
Lincoln, NE 68509
Submit in Duplicate
Attach a certificate of existence from the state or country of incorporation executed by the
official having custody of such records. The certificate must be no more than sixty (60)
days old at the time of filing of this document.
Application for (check one):
____ Initial Registration
____ Renewal
Renewal of a registered name must be filed between October 1st and December 31st
and is effective for the following year.
Name of Corporation_____________________________________________________
Incorporated under the laws of _____________________________________________
Date of Incorporation ____________________________________________________
Business in which corporation is engaged _____________________________________
_____________________________________________________________________
_________________________
DATED
______________________________
Signature
______________________________
Printed Name/Title
NOTE: Every filing must be signed by the chairperson of the board of directors, the president, or one of the officers
of the corporation. If the corporation has not yet been formed or directors have not yet been selected, the filing shall
be signed by an incorporator. If the corporation is in the hands of a receiver, trustee, or other court appointed
fiduciary, the filing shall be signed by that fiduciary.
FILING FEE: $35.00
Revised 12/19/2000
Neb. Rev. Stat. 21-2030 & 21-1933

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