Form S-4 - Form For Use In Filling Quarterly Reports Required By Article 38 Of The Regulation Page 2
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1
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3Form S-4
Page 2
8.
(a)
Total amount received from public since comencement of offering to date $____
(b)
Underwriting discount allowed……$________
(c)
Expenses paid to or for the account of the underwriters.$__________
(d)
Other expenses paid to date by or for the account of the issuer:
(1)
Legal (including organization)…$___________
(2)
Accounting……………..$_________________
(3)
Engineer’s fees incurred
Prior to offering…………..$____________
(4)
Printing and advertising……..$___________
(5)
Other……………$_____________
(e)
Total costs and expenses (b), (c) and (d)…………$__________
(f)
Proceeds to issuer after such deductions (a) minimum (3)…………….$________
9.
Use of net proceeds from commencement of offering to date:
Payment to
Directors and
Payment to
Affiliates
others
(a)
Salaries and fees ……………..
$
$______
(b)
Purchase of real estate………..
$
$______
(c)
Purchase and installation of
machinery and equipment………
$
$______
(d)
Construction of plant building
and facilities……………
$
$______
(e)
Development expense (product
development research,
patent costs, etc.)
$
$______
(f)
Purchase of raw materials,
Inventories, supplies, etc………….
$
$_________
(g)
Selling, advertising, and other
sales promotion………………..
$
$_________
Instruction:
Item 9 of this form need not be completed unless the securities registered
are being offered on behalf of the issuer.
10.
State briefly the nature and extent of each type of the issuer’s principal activities to date
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
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