Uniform Notice Of Transaction Accredited Investor Exemption Form - State Of New Mexico Page 3
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3under this exemption my only be resold pursuant to registration or an exemption under
applicable state securities law.
The undersigned represents that the Issuer is familiar with the conditions that must be satisfied to be
entitled to the Accredited Investor Exemption of the state in which this notice is filed and understands
that the Issuer claiming the availability of this exemption has the burden of establishing that these
conditions have been satisfied.
The Issuer has read this notification and knows the contents to be true and has duly caused this
notice to be signed on its behalf by the undersigned duly authorized person.
Issuer (Print or Type)
Signature
Date
Name (Print or Type)
Title (Print or Type)
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