Notice Of A Transaction Exempt Under Corporations Code Section 31106 - Department Of Corporations Page 2

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6.
Name, title, telephone number and business address of individual to be contacted by the Department
regarding this notice:
Name: __________________________________________________________________________
Title: ___________________________________________________________________________
Business Address: ________________________________________________________________
Telephone: ( ) __________________________________________________________________
7.
Date of this notice: _________________
_________________________________
________________________________
Name of Filer
Authorized Signature
________________________________
Printed Name of Signatory
2

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