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Notice Of A Transaction Exempt Under Corporations Code Section 31106 - Department Of Corporations Page 4

(f)

If the notice form cannot be obtained from the Department, it may be typed on a single

sheet of 8-1/2 inch by 11 inch white bond paper, using one side only. If the space in the

form is insufficient for one or more items, attach a single continuation sheet, designating

the continued information by item number.

(g)

Amendments. An amendment should be filed only for material changes in the information

contained in the notice. There is no fee for an amendment.

Instructions for Completing Form.

Heading:

Department file number. Insert the file number(s) assigned to the filing franchisor or

subfranchisor in any prior filings with the Department under the Franchise Investment

Law.

Item 1. Type of filing. Check the box as appropriate to indicate whether the filing is an initial

filing or subsequent notice.

Item 2. The information provided in parts (a), (b) and (c) relate to the company filing the notice

(i.e., the "filer") which may be the franchisor or a subfranchisor. If a subfranchisor files the notice,

part (d) must be completed to give the name and business address of the franchisor. Part (e) must

state the names associated with the franchisor's business.

Item 3. If the notice is filed by a subfranchisor, the agent(s) for service of process of both the

franchisor and subfranchisor must be furnished.

Item 4. Check the box that applies to indicate the condition in Section 31106 that is claimed as

the basis for the exemption.

Item 5. Specify the name or title given the franchise agreement. Briefly describe the franchised

business (e.g. "restaurant," "retail sales of bicycles"). Check the box to specify whether the

franchise is one to conduct the franchised business (Corp. Code Section 31010) or a subfranchise

(Corp. Code Section 31008.5). Give the names of all the purchasers of the franchise or

subfranchise. State the date of when the sale was consummated.

Item 6. Give the name, title, business address and telephone number of the individual the

Department may contact in connection with the notice.

Item 7. The notice shall be signed on behalf of the filing franchisor or subfranchisor by a person

authorized to do so.

Instructions for Filing the Notice.

The notice must be filed and the fee paid within 15 calendar days after the sale of the franchise.

The notice may be filed, and the fee may be paid, by mail or delivery to any office of the

Department of Corporations. The notice is effective when received with the fee (Section

31106(b)).

Notice Of A Transaction Exempt Under Corporations Code Section 31106 - Department Of Corporations Page 4