Form 260.131 - Department Of Corporations (Page 2 of 2) in pdf

Form 260.131 - Department Of Corporations Page 2

16.

The following undertaking should be made by the issuer named in Item 1 above and, if

the issuer is not the applicant, executed by an authorized officer of the issuer on its

behalf:

The issuer, if it is the applicant, hereby undertakes to furnish the Commissioner promptly

copies of all current, quarterly, semi-annual or annual reports or other material

information concerning its operations furnished to its shareholders during the period a

security is qualified pursuant to this application.

(NOTE: The application must be signed and verified in the following manner.)

The applicant has duly caused this application to be signed on its behalf by the undersigned,

thereunto duly authorized.

_____________________________________________

(Applicant)

By___________________________________________

_____________________________________________

(Title)

I certify (or declare) under penalty of perjury under the laws of the State of California that I have

read this application and the exhibits thereto and know the contents thereof, and that the

statements therein are true and correct.

Executed at______________________________________on_____________________, 20___

(Place)

(Date)

________________________________

(Signature)

Form of Application. The application should be typewritten or written in the English

language, on one side only of either legal or letter-size paper.

Signing of Applications. Application should be signed by an officer or general partner of

the applicant; however, it may be signed by another person holding a power of attorney for such

purposes from the applicant, and if signed on behalf of the applicant pursuant to such power of

attorney, should include as an additional exhibit a copy of said power of attorney or a copy of the

corporate resolution authorizing the attorney to act.

Incorporation by Reference. In lieu of answering any specific item in this form, an

applicant may incorporate the information called for by reference to any attached document, or to

any document currently on file with the Department. Such reference should indicate the pages or

portion of the document where the information is located.

Amendments to Applications. An amendment to any application for qualification should

contain only the information being amended by item number and should be verified in the form

prescribed for the application. Each amendment should be accompanied by a facing page in the

form prescribed by Section 260.131 of the rules on which the applicant shall insert the fact that

the filing is an amendment and the number of the amendment.

260.131 (Rev 9/02)

Form 260.131 - Department Of Corporations Page 2