CHANGE OF REGISTERED AGENT and/or REGISTERED OFFICE LIMITED COOPERATIVE ASSOCIATION
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
Name of Limited Cooperative Association ________________________________________
_____________________________________________________________________________
Current:
Registered Agents Name__________________________________________________________ Registered Agents Address _______________________________________________________
Street and Mailing Address Zip
Registered Office Address ________________________________________NE_____________
Street and Mailing Address City Zip
New:
Registered Agents Name__________________________________________________________ Registered Agents Address _______________________________________________________
Street and Mailing Address Zip
Registered Office Address ______________________________________NE_______________
Street and Mailing Address City Zip
This statement of change is effective when filed. DATED___________________________
___________________________________
Signature of Officer or Authorized Representative
____________________________________
Printed Name and Title
FILING FEE: For Profit $30.00 plus $5.00 per page for any additional pages Not for Profit $10.00 plus $5.00 per page for any additional pages
1/1/2008 2914 Neb. Rev. Stat. 21-