Form K Notice Of Claim Of Exemption Under Section 58-13b-27k, Nmsa 1978 (Page 2 of 2) in pdf

Form K Notice Of Claim Of Exemption Under Section 58-13b-27k, Nmsa 1978 Page 2

II.

GOVERNING INSTRUMENTS

Attach a copy of the Articles of Incorporation, Articles of Organization, Registration of Limited

Liability Partnership, Certificate of Limited Partnership or other instruments of creation of the

Company, including all amendments.

III.

REPRESENTATIONS

The undersigned represents:

That the number of security holders will not in consequence of any sale made under the

exemption afforded by Section 58-13B-27K exceed twenty five.

That sales have been and will be made only to buyers believed to be purchasing for

investment.

That no commissions or other remunerations have been, are being, or will be paid or

given, directly or indirectly, for solicit prospective buyer except to broker dealers and

sales representatives licensed pursuant to the New Mexico Securities Act of 1986.

That neither news releases, advertisements in newspapers, radio, television nor any

other form of public advertising will be used in any manner to contact prospective buyers.

That it understands that acceptance of this notice filing does not constitute approval or

recommendation by the Director of the Securities Division of the securities to be issued

and sold.

That the promoters and persons listed under paragraph II, above, understand the

provisions of Section 58-13B-30, New Mexico Securities Act of 1986, which states that in

connection with the offer to sell, sale, offer to purchase or purchase of a security, a

person shall not, directly or indirectly employ any device, or artifice to defraud; make an

untrue statement of a material fact where such an omission would be misleading; or

engage in an act, practice or course of business which operates or would operate as a

fraud or deceit upon a person.

_______________

______________________________________

Date

Name of Company

______________________________________

Signature and Title of Authorized Person

Form K Notice Of Claim Of Exemption Under Section 58-13b-27k, Nmsa 1978 Page 2