Form 102a - Annual Report (Page 2 of 2) in pdf

Form 102a - Annual Report Page 2

(14) The approximate number of holders of record of each outstanding class of equity securities:

(15) A list in tabular form of the name and address of each officer, and any person known to the registrant who

beneficially owns ten percent or more of any class of outstanding voting securities of the registrant, showing for

each the title of the class owned, the type of ownership, the amount owned, and the percent of class owned:

(16) A list in tabular form of the amount of remuneration received and the capacity in which such remuneration was

received for each officer and director (in the case of officers, only those officers who received in excess of $25,000

during this fiscal year need be listed):

(17) A list and description of the number and exercise price of all options outstanding which are beneficially owned

by any officer or director:

(18) A description of any transactions in the last fiscal year or any currently pending transaction to which the issuer

or any of its subsidiaries was a party and in which any director, officer, ten percent shareholder, or any affiliate had

or will have a direct or indirect material interest, and a description of the nature of such interest.

(19) Financial statements certified by an independent accountant complying with the requirements of parts

2875.0970 and 2875.0980.

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Authorized Signature

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Position

Form 102a - Annual Report Page 2