Instructions For Completing Form Si-Ptsupp - Secretary Of State (Page 2 of 2) in pdf

Instructions For Completing Form Si-Ptsupp - Secretary Of State Page 2

INSTRUCTIONS FOR COMPLETING FORM SI-PTSUPPA

(Type or legibly print in black or blue ink.)

For easier completion, this form is available in a “fillable” version online at the Secretary of State’s website at

The form can be filled in on your computer, printed and mailed to the

Secretary of State, Statement of Information Unit, P.O. Box 944230, Sacramento, CA 94244-2300 or can be delivered

in person to the Sacramento office, 1500 11

Street, Sacramento, CA 95814.

Statutory filing provisions are found in California Corporations Code sections

1502

and 2117, unless otherwise

indicated.

Use this form to add additional directors’ names and information; additional loans made to directors; and any

further information that does not fit on the Corporate Disclosure Statement (Form SI-PTSUPP).

Complete Corporate Disclosure Statement Attachment to Form SI-PTSUPP (Form SI-PTSUPPA) as

follows:

Item A. Insert the name of the corporation exactly as it is of record with the Secretary of State.

Item B. If this attachment adds additional directors:

• Enter the name of each director; the annual compensation (in U.S. dollars) paid to each director;

and the number of any shares or options for shares provided to each director that were not available

to other employees of the corporation.

• Check the applicable box as to whether or not each director has filed bankruptcy within the previous

10 years.

• Check the applicable box as to whether or not each director has been convicted of fraud during the

previous 10 years.

If more than 20 directors, attach additional pages as needed.

Item C. If this attachment adds additional loan(s) made to a director by the corporation at a preferential loan

rate during the previous 24 months, enter a description of each loan including the name of the director

receiving the loan, the amount of the loan (in U.S. dollars) and the terms of the loan. If more space is

needed for the description of the loan, enter the additional information in Item D of this Attachment

(Form SI-PTSUPPA).

If the corporation has made more than 10 loans to the directors, attach additional pages as needed.

Item D. If extra space is needed to complete the information requested on the Corporate Disclosure Statement

(Form SI-PTSUPP) or this Attachment (Form SI-PTSUPPA), please enter the additional information in

Item D.

Please reference the item number from Form SI-PTSUPP or Form SI-PTSUPPA, as

applicable, that corresponds with each item of additional information.

Instructions For Completing Form Si-Ptsupp - Secretary Of State Page 2