Second Notice Of Transaction Pursuant To Corporations Code Section 25102(N) (2006)

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(Department of Corporations Use Only)
DEPARTMENT OF CORPORATIONS FILE NO., if any:
Fee paid with First Notice $ __________
__________________________________________________
Insert File Number(s) of Previous Filings
Before the Department, if any.
2
COMMISSIONER OF CORPORATIONS
STATE OF CALIFORNIA
SECOND NOTICE OF TRANSACTION
PURSUANT TO CORPORATIONS CODE SECTION 25102(n)
Check One: ( ) Transaction under Section 25102(n)
( ) Transaction under Rule 260.103 with Notice pursuant to Section 25102(n)
1.
Name of Issuer: ______________________________________________________________________
2.
Address of Issuer: ____________________________________________________________________
Street
City
State ZIP
Mailing Address: _____________________________________________________________________
Street
City
State ZIP
3.
Area Code and Telephone Number:
_______________________________________________________
4.
Date of Filing of First Notice: ___________________________________________________________
5.
Date of close or abandonment of the offering: ______________________________________________
6.
Title of class or classes of securities to be sold in the transaction:
___________________________________________________________________________________
7.
Type of filing under Securities Act of 1933, if applicable: ___________________________________
_________________________________________________________________________________
8.
Date of Second Notice: _______________
__________________________________
Issuer
( )
__________________________________
Check if issuer already has a consent to
service of process on file with the Commissioner.
Authorized Signature on behalf of Issuer
__________________________________
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.
Second Notice - Section 25102(n)
Revised 3/02

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