APPLICATION FOR CERTIFICATE OF AUTHORITY LIMITED LIABILITY COMPANY
(FOREIGN) Submit in Duplicate
John A. Gale, Secretary of State Room 1301 State Capitol, P.O. Box 94608 Lincoln, NE 68509 (402) 471-4079
http://www.sos.state.ne.us An original certificate of good standing from the appropriate authority in the jurisdiction or state under whose laws the limited liability company was organized must be filed with this document. NOTE: A certified copy of the company's articles of organization may not be filed in lieu of a certificate of good standing.
Name of Limited Liability Company Fictitious Name
(complete only if actual name is unavailable for use or does not comply with Nebraska law)
Address of Principal Business office:
Street Address City State Zip
Organized under the laws of the State of Date of Organization Nature of the Business or purposes to be conducted or promoted in this state:
Name and address of registered agent in Nebraska: Registered Agent Name: Address:
Street Address and post office box number (if any) City
NE______________
Zip
____________________________________
Signature of Member or Manager Printed name of Member or Manger
FILING FEE: $120.00
Revised 02/06/2009 Neb. Rev. Stat. 21-2638