Form Njbos-6 - Registration Statement For Registration By Notification - State Of New Jersey Page 5
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2. Any person owning of record,
__________________________
____________
or beneficially if known, at
least 10% of the outstanding
__________________________
____________
shares of any class of equity
security of the issuer.
__________________________
____________
3. Every promoter of the issuer if
__________________________
____________
the issuer was organized within
the past 3 years.
__________________________
____________
4. If this is a nonissuer distribution, __________________________
____________
any person on whose behalf this
offering is to be made.
__________________________
____________
5. Every underwriter or recipient of __________________________
____________
a finder’s fee (every person listed
in paragraph E).
__________________________
____________
6. Every person who holds or will
__________________________
____________
hold 10% or more in the aggregate
of such options.
__________________________
____________
H. EXHIBITS
Submitted herewith as part of this registration statement are the following documents. (Docu-
ments on file may be incorporated by reference.)
1. A statement of eligibility for registration by notification.
2. A copy of the underwriting or selected dealer agreement (or the proposed form).
3. A copy of any prospectus, pamphlet, circular, form letter, advertisement, or other sales
literature intended to be used in connection with this offering.
4. A consent to service of process of the issuer (with appropriate resolution).
5. The New Jersey Addendum.
6. Financial statements pursuant to N.J.S.A. 49:3-61.2(b)(6), specifically:
(a) A balance sheet of issuer as of a date within 4 months prior to the filing of this registration
statement; and
(b) A summary of earnings for each of the 2 fiscal years preceding the date of the balance
sheet, and summary of earnings for any period between the close of the last fiscal year and
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