Sec Form 1a Regulation A Offering Statement (Page 29 of 29) in pdf

Sec Form 1a Regulation A Offering Statement Page 29

(b) Any additional exhibits which the issuer may wish to ﬁle, which must be so marked as to indicate

clearly the subject matters to which they refer.

SIGNATURES

Pursuant to the requirements of Regulation A, the issuer certiﬁes that it has reasonable grounds to believe that it

meets all of the requirements for ﬁling on Form 1-A and has duly caused this offering statement to be signed on

its behalf by the undersigned, thereunto duly authorized, in the City of _____, State of ____ , on ______ (date).

(Exact name of issuer as speciﬁed in its charter) _________________________________________________

By (Signature and Title) ____________________________________________________________________

This offering statement has been signed by the following persons in the capacities and on the dates indicated.

(Signature) ___________________________________________________________

(Title) ___________________________________________________

(Date) ____________________

Instructions to Signatures:

1. The offering statement must be signed by the issuer, its principal executive ofﬁ cer, principal ﬁnancial

ofﬁ cer, principal accounting ofﬁ cer, and a majority of the members of its board of directors or other governing

body. If a signature is by a person on behalf of any other person, evidence of authority to sign must be ﬁled

with the offering statement, except where an executive ofﬁ cer signs on behalf of the issuer.

2. The offering statement must be signed using a typed signature. Each signatory to the ﬁling must also

manually sign a signature page or other document authenticating, acknowledging or otherwise adopting his or

her signature that appears in the ﬁling. Such document must be executed before or at the time the ﬁling is made

and must be retained by the issuer for a period of ﬁve years. Upon request, the issuer must furnish to the Com-

mission or its staff a copy of any or all documents retained pursuant to this section.

3. The name and title of each person signing the offering statement must be typed or printed beneath the

signature.

Sec Form 1a Regulation A Offering Statement Page 29