Solicitation Of Interest Form Lined

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Solicitation of Interest Form
______________________________________________________
Name of Company
1. Street Address of Principal Office:
2. Company Telephone Number:
3. of Organization:
4. Amount of the Proposed Offering:
5. of Chief Executive Officer:
THIS IS A SOLICITATION OF INTEREST ONLY, NO MONEY OR OTHER
CONSIDERATION IS BEING SOLICITED AND NONE WILL BE ACCEPTED.
NO SALES OF THE SECURITIES WILL BE MADE OR COMMITMENT TO
PURCHASE ACCEPTED UNTIL THE DELIVERY OF A FINAL OFFERING
CIRCULAR THAT INCLUDES COMPLETE INFORMATION ABOUT THE ISSUER
AND THE OFFERING.
AN INDICATION OF INTEREST MADE BY A PROSPECTIVE INVESTOR
INVOLVES NO OBLIGATION OR COMMITMENT OF ANY KIND.
THIS OFFER IS BEING MADE PURSUANT TO AN EXEMPTION FROM
REGISTRATION UNDER THE FEDERAL AND STATE SECURITIES LAWS. NO
SALE MAY BE MADE UNTIL THE OFFERING STATEMENT IS 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.
2. Describe in general how these products or services are to be produced or rendered
and how and when the company intends to carry out its activities.
Offering Proceeds:
3. Describe in general how the company intends to use the proceeds of the proposed
offering.

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