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STATEMENT OF QUALIFICATION AS A LIMITED
LIABILITY PARTNERSHIP
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
Name of Partnership________________________________________________________________
________________________________________________________________________________ (Name must end in
the words: registered limited liability partnership; limited liability partnership; R.L.L.P.; RLLP; "L.L.P." or "LLP" )
_____ Yes, the above named Limited Liability Partnership will engage in the practice of law (if “Yes” you must attach a
current certificate of authority from the Nebraska Supreme Court)
Address of Principal Office__________________________________________________________
Street Address City State Zip
If the Principal Office is not in Nebraska you must provide a Nebraska Office or agent:
Address of Nebraska Office__________________________________________________________
Street Address City State Zip
Or
Agent for Service of process_________________________________________________________
Agent Office_________________________________________________________NE__________
Street Address and post office box number, (if any) City Zip
Optional: The effective date of this filing is ____________ _____, _______
month day year
Registration as a: ___ Domestic LLP
___ Foreign LLP (originally registered out of state) Name of State ____________
Domestic LLPs Only: The above named partnership hereby elects to become a Nebraska Limited Liability Partnership
Neb. Rev. Stat. §67-406 Requires that at least two partners sign the document
Signature of Partner Signature of Partner
Printed Name Printed Name
FILING FEE: $205.00 plus $5.00 for each page in addition to this form.
Add $15.00 for the certificate of authority from the Supreme Court if submitted
Revised 7/18/2008 Neb. Rev. Stat. 67-454 & 67-458
