Application For Registration Of Securities By Qualification Form - State Of Hawaii

ADVERTISEMENT

Dishonored Check Fee - $25
State of Hawaii
Department of Commerce and Consumer Affairs
BUSINESS REGISTRATION DIVISION
335 Merchant Street, Room 203, Honolulu, Hawaii 96813
(808) 586-2722
APPLICATION FOR REGISTRATION OF SECURITIES BY QUALIFICATION
1.
Name and address of issuer.
2.
Address of issuer's principal office in the State, if any.
3.
Amount of offering.
A.
Title and amount of each class of securities being offered in the State and elsewhere.
B.
Offering in the State.
OFFERING
UNDERWRITING DISCOUNTS
NET PROCEEDS
PRICE
AND COMMISSIONS
TO ISSUER
Per Unit
$
$
$
Aggregate
$
$
$
C.
Registration fee
in the State.
(1/10 of 1% of the aggregate offering price of the securities to be sold in the State. Minimum $250; maximum $2,500)
4.
Name of dealer or dealers and their business address who will sell the securities in the State.
(OVER)
S-1
Rev. 07/07
B37 (Fee)

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Legal
Go
Page of 3