Form 260.102.14(C) - Notice Of Transaction Pursuant To Corporations Code Section 25102(F) Page 3

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7. Type of filing under Securities Act of 1933, if applicable: ____________________________________
___________________________________________________________________________________
8. Hardship Exception for electronic filing. An issuer may file this paper notice in person or by mail only
if either of the following exceptions apply. The issuer shall check applicable box and include the
reason(s) and description(s) for the hardship exception in the space provided.
Computer equipment including hardware and software is unavailable to the issuer without
unreasonable burden or expense. If this is the case, describe below both of the following; the
reason(s) that the computer equipment including hardware and software is unavailable without
unreasonable burden or expense, and the description(s) of the unreasonable burden or expense.
The issuer cannot obtain and provide information (including credit card or other identifying
information) requested on the Department's electronic notice or through the Internet filing process. If
this is the case, describe below both of the following: the reason(s) that the issuer cannot obtain and
provide the requested information on the electronic notice or through the Internet filing process
without unreasonable burden or expense, and the description(s) of the unreasonable burden or
expense to the issuer to make the electronic filing.
After checking the applicable hardship exception above, the issuer shall describe below the reason(s) and
description(s) for that hardship exception. (If additional space is needed, attach a separate sheet to this
notice.)
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
9.
Check if issuer already has a consent to service of process on file with the Commissioner. (Instruction:
Each issuer (other than a California Corporation) filing a notice under Section 25102(f) must file a consent to
service of process (Form 260.265), unless it already has a consent to service on file with the Commissioner.
If no consent to service of process is on file with the Commissioner, attach the consent to this notice.)
10. ____________________________________
Authorized Signature on behalf of issuer
______________________________________
Print name and title of signatory
_____________________________________
Date
Name, Address and Phone number of contact person:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

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