0001738246-21-000001.txt : 20210625 0001738246-21-000001.hdr.sgml : 20210625 20210625151028 ACCESSION NUMBER: 0001738246-21-000001 CONFORMED SUBMISSION TYPE: D/A PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b ITEM INFORMATION: 4a5 FILED AS OF DATE: 20210625 DATE AS OF CHANGE: 20210625 EFFECTIVENESS DATE: 20210625 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Nebraska Owner's Insurance Agency, Inc. CENTRAL INDEX KEY: 0001738246 IRS NUMBER: 825172836 STATE OF INCORPORATION: NE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D/A SEC ACT: 1933 Act SEC FILE NUMBER: 021-371792 FILM NUMBER: 211047265 BUSINESS ADDRESS: STREET 1: P.O. BOX 6582 CITY: LINCOLN STATE: NE ZIP: 68506 BUSINESS PHONE: 402-984-2220 MAIL ADDRESS: STREET 1: P.O. BOX 6582 CITY: LINCOLN STATE: NE ZIP: 68506 D/A 1 primary_doc.xml X0708 D/A LIVE 0001738246 Nebraska Owner's Insurance Agency, Inc. 6120 S 58th Street LINCOLN NE NEBRASKA 68516 402-201-7178 NEBRASKA None None Corporation true 2018 Garrett Svoboda 6711 Ridge Road Lincoln NE NEBRASKA 68512 Executive Officer Director Promoter Tydd Rohrbough 418 Pine St. Pleasant Dale NE NEBRASKA 68423 Director Promoter Chad Lindburg 12415 N Road Stromsburg NE NEBRASKA 68666 Director Promoter John Groeteke 1050 300th Street Primrose NE NEBRASKA 68655 Director Promoter Bryan Barnell 7360 Upton Grey Lane Lincoln NE NEBRASKA 68516 Director Promoter Angela Kohmetscher 7433 S. 28th Street Lincoln NE NEBRASKA 68516 Promoter Other $1 - $1,000,000 06b 4a5 true 0001738246-20-000001 2020-08-06 false true false 2500 2500000 1167500 1332500 false 125 0 0 200000 true This amount has been reduced from the amount listed in the initial Form D submission, due to the death of Kevin Keegan, who was formerly an officer, director and promoter who received payments. false Nebraska Owner's Insurance Agency, Inc. /s/ Garrett Svoboda Garrett Svoboda President 2021-06-25