Free Domestic Change of Registered Agent and/or Office - Nebraska

DOMESTIC CHANGE OF REGISTERED AGENT and/or OFFICE
Submit in Duplicate John A. Gale, Secretary of State Room 1301 State Capitol, P.O. Box 94608 Lincoln, NE 68509 http://www.sos.state.ne.us The following corporation, pursuant to the laws of the state of Nebraska, does hereby wish to change its Registered Agent and/or Registered Office. Name of Corporation__________________________________________________________ Previous: Registered Agent: Registered Office: New: Registered Agent: Registered Office*: ___________________________________________________________ _________________________________________NE_______________
Street Address and Post Office Box (if any) City Zip

__________________________________________________________ ________________________________________NE________________
Street Address and Post Office Box (if any) City Zip

* The street address of the registered office and the street address of the registered agent must be identical. 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. Signing a false document which is filed or attempted to be filed with the Secretary of State is a Class I Misdemeanor, subject to up to one year imprisonment or a $1000 fine, or both.
____________________________________________________________________________________________________________________ __ ____________________________________________________________________________________________________________________ __

Registered Agent: Please check A (current agent) or B (new agent) below and sign ____ A. I hereby state that the above named corporation has been notified of the change in address of my registered office. ____B. I hereby consent to act as registered agent for the above named corporation. ___________________________________
Signature of Registered Agent
__________________________________________________________________________________________________________________

FILING FEE: $30.00
Revised 07/18/2008 Neb. Rev. Stat. §21-2032