Explanatory Statement Form - 1999 Page 5
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STATEMENT OF NON-PREJUDICE
I, the undersigned investor to whom securities were sold without compliance
with the registration provisions of the Connecticut Uniform Securities Act (the “Act”),
acknowledge that:
1.
I have read the preceding Explanatory Statement;
2.
I am satisfied that I have not been defrauded, damaged or prejudiced by
the failure to register these securities; and
3.
I understand that I have not waived any of my rights under the Act by
signing this Statement of Non-Prejudice.
_______________________________________
(Signature of Investor)
_______________________________________
(Date Signed)
_______________________________________
(Print Name of Investor Signing)
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