Form 133.11 - Sales Report For Non-Continuous Offerings - Texas State Securities Board
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1Form
133.11
Texas State Securities Board
P.O. Box 13167
Austin, Texas 78711-3167
Sales Report for Non-continuous Offerings
In order to comply with §113.10, you should furnish the information requested in the tabulation
below. If this is to be a final sales report indicate the total expenses of the offering.*
PERMIT NO.
__________________
FINAL REPORT:
Yes
No
G
G
For the Period: FROM
_________________
TO
__________________
# Shares
$ Consideration
1.
Balance UNSOLD in Texas
Beginning Period
1
__________
_____________________
2.
Add: Increase of Offering in Texas
by Permit Amendment
2
During the Period
__________
_____________________
3.
Deduct: Amount SOLD in Texas
3
During Period
__________
_____________________
4.
Balance of Authorization in
Texas UNSOLD on
(Date) _________________
__________
_____________________
*Total Offering Expenses (to be
completed in Final Report ONLY)
__________
_____________________
Total Sales in all States including Texas
__________
_____________________
Name of Issuer:
By:
Date:
1
The offering UNSOLD at the beginning of a report period is the BALANCE of authorization
UNSOLD at the previous reporting period. For first year Permits this total is the aggregate authorization of the
original Permit.
2
Increase to authorized offerings result only from formal amendments to Permits.
3
This deduction is the TOTAL amount of any commitments for SHARES SOLD. Liquidations,
abandonments or cancellations may not be deducted from the amount of certificates SOLD, nor added to any
authorized UNSOLD balance.
08-16-2010
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