SECURITIES AND BUSINESS REGULATION 237 Coliseum Drive Macon, Georgia 31217-3858 (478) 207-2440       BRIAN P. KEMP   Commissioner of Securities                http://www.sos.state.ga.us/securities              RESCISSION NOTICE AND NOTIFICATION FORM Georgia Uniform Securities Act of 2008 O.C.G.A. § 10-5-23 INSERT THE FOLLOWING NOTICE OF RESCISSION on the inside front cover page of the prospectus in the case of a printed prospectus or on the second page of the prospectus in the case of a prospectus reproduced by any other means, in boldfaced print or CAPITAL type: ANY PERSON WHO PURCHASES THE SECURITIES OFFERED HEREBY SHALL HAVE THE UNQUALIFIED AND UNWAIVABLE RIGHT TO RESCIND SUCH PURCHASE WITHIN THREE (3) BUSINESS DAYS OF THE EXECUTION OF A WRITTEN AGREEMENT TO PURCHASE ANY SECURITIES OFFERED HEREBY, THE DELIVERY OF A CONFIRMATION OF SALE, OR THE PAYMENT FOR ANY SECURITIES OFFERED HEREBY, WHICHEVER SHALL OCCUR FIRST. RESCISSION MAY BE ACCOMPLISHED BY COMPLETING AND MAILING THE FORM PROVIDED ON PAGE ______ OF THIS PROSPECTUS. INSERT THE FOLLOWING NOTIFICATION OF RESCISSION on the inside back cover page in the case of a printed prospectus or the final page in the case of a prospectus reproduced by any other means, to provide a means of exercising the right of rescission provided in section 10-5-23 of the Georgia Uniform Securities Act of 2008. Separate forms are required, addressed to both the issuer and the Commissioner of Securities. NOTICE OF RESCISSION TO: COMMISSIONER OF SECURITIES OFFICE OF THE SECRETARY OF STATE 237 COLISEUM DRIVE MACON, GEORGIA 31217 I hereby exercise my right to rescind my purchase of ____________shares of the________________________________. __________________________________________ (Name of Issuer/Company) This rescission is made within three (3) business days of the earliest of my execution of a written agreement to purchase said shares, the delivery of a confirmation of sale of said shares to me or the payment for such shares, the delivery of a confirmation of sale of said shares to me or the payment for such shares. I understand that the effective date of the rescission shall be the date of delivery of this Notice or the depositing of same, properly addressed with adequate postage thereon, in the United States Mail. DATED, this _______________day of __________________________, 20___ SIGNATURE ____________________________________________________________________________ NAME ____________________________________________________________________________ ADDRESS _________________________________________________________________________ CITY ______________________________________ STATE ____________ ZIP CODE ___________ Form 8-NR-2 Rev. 2/2011 American LegalNet, Inc. www.FormsWorkFlow.com