Form 14-25s - Notice Of Sale Of Securities Pursuant To Accredited Investor Exemption - Utah Page 2

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Form 14-25s
(Rev. 11/16/1998)
Page 2of 2
5. Description of Business:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
___________________________________________________________________
6. Name and Business Address of any Broker-Dealer who has solicited or intends to solicit
purchasers in Utah:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
By filing this Notice of Transaction, the Issuer of these securities understands that:
(1)
Sales of securities shall be made only to persons whom the issuer reasonably believes
are accredited investors as defined in 17CFR 230.501(a).
(2)
The issuer is not an issuer in the development stage that either has no specific business
plan or purpose or has indicated that its business plan is to engage in a merger or
acquisition with an unidentified company or companies, or other entity or person.
(3)
The issuer reasonably believes that all purchasers are purchasing for investment and
not with the view to or for sale in connection with a distribution of the security. Any
resale of a security sold in reliance on this exemption within 12 months of sale shall
be presumed to be with a view to distribution and not for investment, except a resale
pursuant to an effective registration statement or to an accredited investor pursuant
to an available exemption.
The undersigned represents that the issuer is familiar with the conditions that must be satisfied to be
entitled to the Accredited Investor Exemption of Utah in which this notice is filed and understands
that the issuer claiming the availability of this exemption has the burden of establishing that these
conditions have been satisfied.
The issuer has read this notification and knows the contents to be true and has duly caused this notice
to be signed on its behalf by the undersigned duly authorized person.
___________________________
_________________________________
____________
Issuer (Print or type)
Signature
Date
___________________________
_________________________________
Name (Print or type)
Title

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