Application For Electronic Access Of Records | Pdf Fpdf Docx | Nebraska

 Nebraska   Secretary Of State   Limited Liability Company 
Application For Electronic Access Of Records | Pdf Fpdf Docx | Nebraska

Last updated: 8/13/2025

Application For Electronic Access Of Records

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Description

APPLICATION FOR ELECTRONIC ACCESS OF RECORDS. This form is used by limited liability companies in Nebraska that provide health-related professional services to apply for electronic access to records with the Office of the Secretary of State. It collects detailed information about the LLC’s members, managers, and professional employees who are legally required to hold licenses or certifications to perform the company’s professional services. The form requires listing each individual’s full name, license number, and residential address, and it must be completed in full for all applicable individuals. An authorized representative of the LLC must sign and date the application, and a filing fee is required for submission. Neb. Rev. Stat. § 21-186. www.FormsWorkflow.com

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