Form 260.100.3 - Request For Order Of Exemption (Page 2 of 3) in pdf

9. State the principal transactions out of which the securities arise or the principal purposes for which the net

proceeds of the sales of such securities are to be used and the approximate amount intended to be used for

each such transaction or purpose.

10. Attach as exhibits, if applicable, the following which are hereby incorporated by reference.

a. Financial statements of the Issuer as required by Section 260.613 of Title 10 of the California Code of

Regulations.

b. Copies of the Issuer's most recent Form 10-K and Form 8-K filings with the Securities and Exchange

Commission (or the filings of the parent if the Issuer has not made such filings).

c. Copies of each of the most recent ratings by nationally recognized statistical rating organizations of

the Issuer's securities issuable pursuant to the exemption under Section 25100 (l), or a description

thereof if copies are not available.

d. A schedule which sets forth the Issuer's ratio of earnings to fixed charges, current ratio, quick asset

ratio and inventory turnover (all based on the Issuer's most current financial information).

e. A copy of any "no action" letters issued by the Securities and Exchange Commission regarding

whether the Issuer's securities are exempt from the registration requirements of the Securities Act of

1933 pursuant to Section 3(a)(3). If no such letters have been requested or received, attach an opinion

of counsel that such securities are so exempt.

11. Are any of the Issuer's securities in default?

12. Describe any material changes which may have occurred subsequent to the dates of any financial

statements or information submitted. Is the Issuer aware of any information which would give rise to

questions regarding the ratings disclosed under Item 10c? If so, describe the information.

13. There is no adverse order, judgment or decree entered in connection with Issuer's debt securities that

are exempt pursuant to Section 25100 (l), or similar exemption in another jurisdiction, or Section 3(a)(3) of

the Securities Act of 1933, by any state regulatory authority, any court, or the Securities and Exchange

Commission, except as follows: (If none, so state)

14. Submit any additional statements or information which will assist the Commissioner in determining

whether qualification of such securities is necessary or appropriate in the public interest or for the protection

of investors.

15. The Issuer agrees, in the event it does not reapply for an exemption under Subdivision (1) of Section

25100, to furnish the information specified in Item 5 above for the period during which the exemption herein

applied for is in effect, if granted, within 90 days after the expiration of such exemption.

The Issuer has duly caused this request to be signed on its behalf by the undersigned, thereunto duly

authorized.

________________________________

(Issuer)

By______________________________

(Title)

260.100.3 (Rev. 9/02)

Form 260.100.3 - Request For Order Of Exemption Page 2