Form Va-1 Notice Of Limited Offering Of Securities Page 4

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FORM VA-1 Part 2
(Rev. 11/96)
COMMONWEALTH OF VIRGINIA
STATE CORPORATION COMMISSION
DIVISION OF SECURITIES AND RETAIL FRANCHISING
NOTICE OF LIMITED OFFERING OF SECURITIES
PURSUANT TO 21 VAC 5-40-100 OF THE SECURITIES ACT RULES
Issuer limited transactional exemption.
An issuer must deliver Part 2 of Form VA-1 or a disclosure document containing the information required
by Part 2 of Form VA-1 to all purchasers, if:
1.
Within 18 months prior to the first sale of securities under this rule, the issuer has issued or
committed to be issued securities of the same or a similar class for consideration of a value 25 % or
more below the offering price of securities to be sold under this rule, if the securities issued or committed
to be issued constitute 10% or more of the securities of the same or a similar class outstanding at the
beginning of the offering under this rule, or if the securities were issued or committed to be issued to an
officer, director, general partner, trustee, or promoter of the issuer; or
2.
The entire proceeds of the offering under this rule are not to be escrowed in a bank, as defined in
the federal Securities Act of 1933, §3(a)(2), or a savings and loan association or similar institution as
defined in the federal Securities Act of 1933, §(3)(a)(5), until completion of the offering.
(a)
Indicate the names of officers, directors, general partners, trustees (if a real estate
investment trust) or promoters of the issuer to whom any amount of securities of the
issuer has been, or is to be, issued at a price of 25% or more below the offering price of
this offering, regardless of the percentage of securities of the Issuer this represents, if
issued or committed to be issued within the last 18 months.
NAME
CLASS/TYPE
NO. OF SHARES
PRICE
(b)
Indicate the names of any persons other than those named in paragraph (a), above, to
whom securities aggregating 10% or more of the total securities outstanding at the
beginning of this offering have been issued or committed to the issued within the last 18
months and which were issued or are to be issued at a price 25% or more below the
offering price of this offering.
NAME
CLASS/TYPE
NO. OF SHARES
PRICE

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