Application For Exemption From Registration - Montana State Auditor Commissioner Of Securities

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STATE OF MONTANA
APPLICATION FOR
MONICA J. LINDEEN
STATE AUDITOR
EXEMPTION
COMMISSIONER OF SECURITIES
840 Helena Avenue
FROM REGISTRATION
Helena, Montana 59601
(406) 444-2040
1.
Name, address, and telephone number of issuer.
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
2.
Name, address, and telephone number of contact person.
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
3.
Description of Securities.
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Type
Units
Amount
Units in MT
Amt. in MT
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_______
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______________
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4(a). List the states in which it is proposed to offer the securities for sale.
_______________________________________________________________________
_______________________________________________________________________
4(b). List the states in which the securities are eligible for sale.
_______________________________________________________________________
_______________________________________________________________________
4(c). List the states which have refused, by order or otherwise, to authorize the sale of
the securities, or have revoked or suspended the right to sell the securities, or in which
an application has been withdrawn.
_______________________________________________________________________
_______________________________________________________________________
5.
State the federal statute or rule under which the offering will be made.
_______________________________________________________________________

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