Application For Withdrawal Of Foreign Limited Liability Company - Nebraska Secretary Of State

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APPLICATION FOR WITHDRAWAL
OF FOREIGN
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_________________________________________
_____________________________________________________________________
Organized under the laws of the State of _________________________
The company is no longer transacting business in the State of Nebraska and surrenders its
authority to transact business in the state of Nebraska
The limited liability company revokes the authority of its registered agent in this state to
accept service of process and consents that service in any action suit or proceeding based
upon any cause of action arising in this state during the time the limited liability company
was authorized to transact business in this state be made on the company outside the state.
Post office address at which process against the company may be served:
_____________________________________________________________________
Street Address
City
State
Zip
____________________________________
___________________________________
Signature of Member
Printed name of Member
FILING FEE: $25.00
Revised 12/19/2000
Neb. Rev. Stat. 21-2642

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