[Your Name] [Your Address] [City, State, ZIP] [Email Address] [Phone Number] [Date] [Nebraska Secretary of State] [Business Division] [Address] [City, State, ZIP] Subject: Request for Certificate of Administrative Dissolution — Revocation Dear Sir/Madam, I am writing to request a Certificate of Administrative Dissolution — Revocation for my business entity that was previously filed with the Nebraska Secretary of State. I have outlined the necessary information and enclosed the required documents as follows: 1. Business Entity Information: — Entity Name: [Enter your business entity name exactly as it appears on record] — Business Entity ID/Number: [Enter your unique identification number assigned by the Secretary of State] 2. Reason for Certificate: — AdministrativDissolutionio— - Revocation 3. Supporting Documents Checklist: — Completed Certificate of Administrative Dissolution — Revocation For— - Payment of the applicable fee as specified by the Nebraska Secretary of State — Any additional supporting documents required by the Nebraska Secretary of State I kindly request that you verify the completeness and accuracy of the enclosed documents. If any additional documents or information are required for processing, please inform me promptly so that I may provide them to you. I am available for any inquiries or further documentation required in order to expedite the processing of this request. If necessary, please contact me via email or phone number provided above. Thank you for your prompt attention to this matter. I look forward to receiving the Certificate of Administrative Dissolution — Revocation in due course. Sincerely, [Your Name]