Statement Of Intent To Dissolve Llc Form - Ne Secretary Of State

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STATEMENT OF INTENT
TO DISSOLVE
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_________________________________________
_____________________________________________________________________
This statement of intent to dissolve the above named limited liability company is being filed
due to the occurrence one of the following events specified in Neb. Rev. Stat. §21-2622
and described below:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Or
___________________________________
____________________________________
Signature of Member
Signature of Manager
Or
___________________________________
____________________________________
Printed Name of Member
Printed Name of Manager
FILING FEE: $15.00
Revised 12/19/2000
Neb. Rev. Stat. 21-2623

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