Form 08-112 Report Of Securities Sales And Use Of Proceeds - Administrator Of Securities Division Of Banking, Securities, And Corporations

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REPORT OF SECURITIES SALES AND USE OF PROCEEDS
Complete and return to:
Administrator of Securities
Division of Banking, Securities, and Corporations
P.O. Box 110807
Juneau, AK 99811-0807
(907) 465-2521
:______________________
Alaska file number
:
Registrant name
Managing underwriter: (if any)
Date offering commenced:
Date offering completed:
Total amount of securities registered: $
Amount registered in Alaska: $
Amount of securities sold in Alaska: $
Total amount received from the public: $
Use of proceeds, itemized statement:
(List separately a) underwriting discounts and
commissions; b) expenses paid to or for underwriters; c) other expenses of the offering paid by or
for the account of the registrant; and d) other purposes for which a substantial amount of
proceeds were used. For each category, list separately payments to directors, officers, and
affiliates. If any proceeds were used for purposes other than in the prospectus, please state the
reason for deviating. If all proceeds were used as indicated in the prospectus, please so state.)
Continue on back of form
08-112 (10/99)

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