Form 14-25v - Accredited Investor Exemption Uniform Notice Of Transaction (Page 2 of 2) in pdf

Form 14-25v

(Rev. 12/15/2011)

Page 2 of 2

5. Description of Business:

___________________________________________________________________________

6. Name and Business Address of any Broker-Dealer who has solicited or intends to solicit

purchasers in Utah:

___________________________________________________________________________

By filing this Notice of Transaction, the Issuer of these securities understands that:

(1)

Sales of securities shall be made only to persons whom the issuer reasonably believes are accredited

investors as defined in 17CFR 230.501(a).

(2)

The issuer is not an issuer in the development stage that either has no specific business plan or

purpose or has indicated that its business plan is to engage in a merger or acquisition with an

unidentified company or companies, or other entity or person

(3)

The issuer reasonably believes that all purchasers are purchasing for investment and not with the

view to or for sale in connection with a distribution of the security. Any resale of a security sold in

reliance on this exemption within 12 months of sale shall be presumed to be with a view to

distribution and not for investment, except a resale pursuant to an effective registration statement or

to an accredited investor pursuant to an available exemption.

The undersigned represents that the issuer is familiar with the conditions that must be satisfied to be entitled

to the Accredited Investor Exemption of Utah in which this notice is filed and understands that the issuer

claiming the availability of this exemption has the burden of establishing that these conditions have been

satisfied.

The issuer has read this notification and knows the contents to be true and has duly caused this notice to be

signed on its behalf by the undersigned duly authorized person.

___________________________

_________________________________

____________

Issuer (Print or type)

Signature

Date

_________________________________

Name (Print or type)

Title

Form 14-25v - Accredited Investor Exemption Uniform Notice Of Transaction Page 2