Form 203-O - Application Under Section 203(O) Of The Pennsylvania Securities Act Of 1972 - 2013 Page 2
ADVERTISEMENT
1
2
34.
(A) Legal Form of Issuer (Corporation, Partnership, etc.):________________________________
(B) State and Date of Incorporation of
formation:_______________________________________
State
Date
(C) Describe briefly the nature of Issuer’s business.
5.
Describe type and amount of securities proposed to be issued in the reorganization or other
transaction with respect to which this Application is being filed.
6.
Attach a copy of the proxy statement, prospectus and all other information submitted, or to be
submitted, to security holders in connection with the transaction.
7.
State the number of security holders, and the number of shares or other units held by persons who
are residents of Pennsylvania. State also the total number of security holders to whom the
offering is to be made and the total number of shares or other units held by them.
8.
Describe all sales of securities directly or indirectly for the benefit of the Issuer made in this
Commonwealth during the past three years. Include securities issued in exchange for property,
services or other securities and new securities resulting from the modification of outstanding
securities. In each case, state:
(A)
The date of sale and title and amount of securities sold;
(B)
Class of persons to whom securities were sold;
(C)
Per unit and aggregate offering price or nature of consideration paid;
(D)
Underwriting or selling fees or commissions;
(E)
The exemption or other provision of the Pennsylvania Securities Act relied upon and the
facts upon which such reliance is based;
9.
Affirmation.
By executing this Form on behalf of the issuer, the signatory affirms that:
A. A copy of the proxy or other materials referred to in Item 6 has been or will be mailed to all
affected security holders in accordance with applicable state laws.
FORM 203-O
4
REVISED: 7/31/2013
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form No. 15h - Declaration Under Section 197a (1a) Of The Income Tax Act, 1961 To Be Made By A Persons Claiming Receipt Of Interest Other Than "interest On Securities" Or Income In Respect Of Units Without Deduction Of Tax
Financial
Form No. 15h - Declaration Under Section 197a(1c) Of The Income-tax Act, 1961 To Be Made By An Individual Who Is Of The Age Of Sixty Years Or More Claiming Certain Receipts Without Deduction Of Tax
Financial
Form No. 15h - Declaration Under Section 197a(1c) Of The Income-tax Act, 1961 To Be Made By An Individual Who Is Of The Age Of Sixty Years Or More Claiming Certain Receipts Without Deduction Of Tax
Financial
Form No. 15h - Declaration Under Section 197a(1c) Of The Incometax Act, 1961 To Be Made By An Individual Who Is Of The Age Of Sixty Years Or More Claiming Certain Receipts Without Deduction Of Tax
Financial
Form No. 15h - Declaration Under Section 197a(1c) Of The Incometax Act, 1961 To Be Made By An Individual Who Is Of The Age Of Sixty Years Or More Claiming Certain Receipts Without Deduction Of Tax
Financial
Related Categories
Parent category: Legal