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 http://www.sos.state.ne.us 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