Form Sra - Addendum To Business Organization And Registration Forms Statement Of Compliance With New Hampshire Securities Laws Page 2

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Instructions for
Form SRA – Addendum to Business Organization and Registration Forms
Statement of Compliance with New Hampshire Securities Laws
This form is required for all businesses being formed or registering in the state of New Hampshire. New
Hampshire law requires that before your application for business registration is accepted, you must provide a
statement that your business has complied with the state’s securities law. A security is an ownership interest in a
business. For example, a share of stock is a security and so is an interest in a limited liability company or a
limited partnership . So, for example, if you and your spouse own the sole interests in a limited liability company,
those interests are securities. Generally, a business that issues securities in New Hampshire must either register
the securities with the New Hampshire Bureau of Securities Regulation or claim a valid exemption. There are
several exemptions from the requirement to register securities. The most common exemption is the exemption
described in Part II, Item 1.
Please read the following instructions for each part of Form SRA. These instruction will help you to provide
accurate responses.
Part I: Please provide the business name and address, including number, street, city, state and zip code. In
addition, please provide the businesses telephone number, e-mail address – if any – a contact person name and
the contact person’s full address if different from the business address.
Part II: Check only ONE item in this part. If more than one item is checked, this form will be rejected.
1. Your business is qualified for the exemption from registration in Item 1 if it meets ALL of the requirement
listed in A), B), and C) below :
A) The business has 10 or fewer owners. So, for example, if you and your wife are forming a limited
liability company and there are no other owners, you meet this requirement for an exemption; AND
B) Advertising relating to the sale of ownership interests in your business has not been circulated.
Please note that this requirement asks whether you have circulated advertising related to the offer
or sale of ownership interests. This requirement does not address advertising related to the sale of
your products or services. So, for example, if you advertise that you are selling shares of stock in
your corporation, then you do not meet this requirement and cannot claim the exemption; AND
C) Sales of ownership interests – if any – will be completed within 60 days of the formation of the
business. If you do not intend to sell any further ownership interests in your business, then you meet
this requirement for an exemption. If you intend to sell more ownership interests in your business
and will complete all sales within 60 days, then you meet this requirement. However, if the sale of
any ownership interests will occur later than 60 days after the formation of the business, you
do not meet this requirement and cannot claim the exemption.
If you meet all of these requirements, you may then check off Item 1 and claim this exemption.
2. If you can claim a different registration exemption from the one listed in Item 1 or if you are offering federal
covered securities that only require a notice filing in New Hampshire, you should check Item 2. In addition,
you must cite the statute for the exemption which you are claiming or for the type of notice filing you are
making.
3. If a New Hampshire business or a business formed in a state other than New Hampshire intends to offer
ownership interests for sale and is not subject to any exemption from registration, the securities must be
registered with the Bureau of Securities Regulation. If this is the case, you should check Item 3. In addition,
you should provide us with the date that you registered the securities or that you intend to register the
securities.
1
Rev. 4/04

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