Form U-1 - Uniform Application To Register Securities
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5Form U-1
Uniform Application to Register Securities
Application to _____________________________________ of the State of ______________________
pursuant to Section _________________________________ of the _____________________________
1. Name and Address of Issuer and principal office in this state:
_________________________________________________________________________________
2. Name, address and telephone number of correspondent to whom notices and communications
regarding this application may be sent:
_________________________________________________________________________________
3. Name and address of applicant:
_________________________________________________________________________________
4. Registration or acceptance for filing is sought for the following described securities in the amounts
indicated:
_________________________________________________________________________________
Total Offering
Offering in this State
Offering Price
Descriptions of
or Proposed
No. of Shares
No. of Shares
Securities
Offering Price
or Units
Amount
or Units
Amount
$
$
$
$
$
$
Totals
$
$
Indicate the maximum commission to be charged: ________________%
5. Amount of filing and examination fees which are enclosed: $_______________ $_______________
6. A Registration Statement was filed with the Securities and Exchange Commission on ____________
and
became
will become effective on ___________________.
7. (a) List the states in which it is proposed to offer the securities for sale to the public.
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Parent category: Legal