First Notice Of Transaction Pursuant To Corporations Code Section 25102(N)(2006) (Page 2 of 3) in pdf

First Notice Of Transaction Pursuant To Corporations Code Section 25102(N)(2006) Page 2

Filing of Disclosure Statements. Check one:

( )

Copies of the disclosure statements and subscription agreements are attached; or

( )

Copies of the disclosure statements and subscription agreements will be filed with the

Commissioner within 10 days of filing this notice. Failure to comply with this request may

result in an administrative penalty of up to $1,000.

General Announcement of the Offering. Check one:

( )

A general announcement of the offering was not made and will not be made.

( )

A copy of the general announcement of the offering is enclosed with this notice.

Date of Publication: ________________________________________

Method of Publication (e.g., newspaper, other publications, Internet):

________________________________________________________

10.

Undertaking: The issuer undertakes to deliver the disclosure statement required by paragraph (4) of

Corporations Code Section 25102(n) to be delivered to specified qualified purchasers, and any

supplement thereto, to the Commissioner within 10 days of the Commissioner's request for the

information.

11. Date of First Notice: _______________

__________________________________

Issuer

( )

__________________________________

Check if issuer already has a consent to

Authorized Signature on behalf of Issuer

service of process on file with the Commissioner.

__________________________________

Print name and title of signatory

Name, Address, and Phone number of contact person:

__________________________________________________________________________________

Instruction: Each issuer (other than a California Corporation) filing a notice under Section 25102(n) must also file a Consent

to Service of Process (Form 260.165), unless it already has a valid consent to service on file with the Commissioner.

First Notice - Section 25102(n)

First Notice Of Transaction Pursuant To Corporations Code Section 25102(N)(2006) Page 2