Form S-4 - Form For Use In Filling Quarterly Reports Required By Article 38 Of The Regulation Page 3
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3Form S-4
Page 3
11.
State whether the offering has been discontinued, and if so, state the date and describe
briefly the reasons for such discontinuance.
________________________________________________________________________
________________________________________________________________________
12.
List the names and addresses of all brokers and dealers who have, to the knowledge of
the issuer or underwriters, participated in the distribution of the securities offered during
the period covered by this report.
________________________________________________________________________
________________________________________________________________________
Instructions:
In reports made subsequent to the initial report, the information need be given
only with respect to persons not previously reported.
13.
State the number of shares held by each promoter, director, officer or controlling person
of the issuer, if different from the amount stated in the prospectus.
Date ________________________________
Issuer __________________________
By ____________________________
Name and title
_______________________________
Selling security holder
________________________________
Applicant registering securities
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