Form Fis 0564 - Application To Register Securities By Notification (Page 3 of 5) in pdf

Form Fis 0564 - Application To Register Securities By Notification Page 3

If the selling discounts and commissions are variable, state the basis of determining them and their maximum and minimum amount

State the estimated amounts of other selling expense, including legal, engineering and accounting charges

State the name and address of every underwriter and every recipient of a finder's fee

If the securities are not to be offered through an underwriter, describe the plan of distribution

6. Describe fully any stock options or other security options outstanding (giving exercise price, amount of securities

involved, terms, and by whom held)

Furnish the same information as to any options to be created in connection with this offering

Note: In answering question 6, submit the requested information separately as to (1) each director or officer of the

issuer or person occupying a similar status or performing similar functions, (2) any person owning of record, or

beneficially if known, 10% or more 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 non-issuer

distribution, any person on whose behalf this offering is to be made, (5) every person named in your answer to

question 5(h), and (6) every person who holds or will hold 10% or more in the aggregate of such options.

Form Fis 0564 - Application To Register Securities By Notification Page 3