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Get NE Form 5 2010

Do you hold, or have you previously held, a Nebraska Identification Number? NO YES If Yes, enter number: 3 County of Business Location in Nebraska PLEASE DO NOT WRITE IN THIS SPACE 4 Bus. Class. Code (Dept. of Revenue Use Only) NAME AND LOCATION ADDRESS NAME AND MAILING ADDRESS Name Name Doing Business As (dba) Legal Name Street Address (Do not use P.O. Box) City Street or Other Mailing Address State Zip Code City State Zip Code 5 Type of Ownership (1) Sole Proprietorship (4).

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