Solicitation Of Interest Form - State Of Pennsylvania

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NOTE TO USERS: The following form sets forth the minimum informational requirement for soliciting
indications of interest under federal and state securities laws. You may include additional inform ation if
you think it necessary or desirable. Remember that any discussion in this document is subject to the anti-
fraud provisions of the federal and state securities laws and must therefore be complete. You may not
exaggerate the investment opportunity, minimize the risks of the enterprise or predict revenues, profits or
payment of dividends (including financial projections and forecasts).
You may alter the graphic
presentation of the form in any way as long as the minimum inform ation is clearly presented. The
information in the Pennsylvania SOI Supplement is an integral part of the SOI Form and MUST
accompany the SOI Form inform ation at all times and under all circumstances.
SOLICITATION OF INTEREST FORM
NAME OF COMPANY
Street Address of Principal Office:
Company Telephone Number:
Date of Organization:
Amount of the Proposed Offering:
Name of Chief Executive Officer:
THIS IS A SOLICITATION OF INTEREST ONLY. NO M ONEY OR OTHER CONSIDERATION IS BEING
SOLICITED AND NONE W ILL BE ACCEPTED.
NO SALES OF THE SECURITIES W ILL BE M ADE OR COM M ITM ENT TO PURCHASE ACCEPTED UNTIL
THE DELIVERY OF A FINAL OFFERING CIRCULAR OR PROSPECTUS THAT INCLUDES COM PLETE
INFORM ATION ABOUT THE ISSUER AND THE OFFERING.
AN INDICATION OF INTEREST M ADE BY A PROSPECTIVE INVESTOR INVOLVES NO OBLIGATION
OR COMM ITM ENT OF ANY KIND.
THIS OFFER IS BEING M ADE PURSUA NT TO AN EXEM PTION FROM REGISTRATION UNDER THE
FEDERAL AND STATE SECURITIES LAW S. NO SALE M AY BE M ADE UNTIL THE OFFERING IS
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QUALIFIED BY THE SEC AND IS REGISTERED IN THIS STATE
This Company ( ) Has never conducted business operations.
( ) Is in the development stage.
( ) Is currently conducting operations.
( ) Has shown a profit for the last fiscal year.
( ) Other (specify)
BUSINESS:
1. Describe in general what business the company does or proposes to do, including what products or
goods are or will be produced or services that are or will be rendered.
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The language "IS QUALIFIED BY THE SEC AND" is not applicable if the offering is made under Section 3(a)(11) of the
federal Securities Act of 1933.
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