Notice of Exempt Securities Transactions Under AS 45.55.900(b)(4)and 3 AAC 08.910(5) (To be filed along with the required fee described at 3 AAC 08.920(6)) Please fill out this form and submit to: Administrator of Securities Alaska Division of Banking, Securities, and Corporations P.O. Box 110807 Juneau, AK 99811-0807 (907) 465-2521 STATUTORY REFERENCE: AS 45.55.900(b)(7) The following transactions are exempted from AS 45.55.070 and 45.55.075: (4) an offer or sale to a bank, savings institution, trust company, insurance company, investment company as defined in 15 U.S.C. 80a-1 - 80a-64 (Investment Company Act of 1940), pension or profit-sharing trust, or other financial institution or institutional buyer, or to a broker-dealer, whether the purchaser is acting for itself or in some fiduciary capacity; The .900(b)(4) exemption is self-executing when the issuance would go to the institutions specifically named, and if you limit the offer to those, requires no filing. If, however, you wish to offer to other institutions or to have the division confirm that the institutions to which you plan sales are qualified under AS 45.55.900(b)(4), you must use this form. 1. Name, Address and Telephone number of person filing this notice: Full Name Address Phone Fax The person signing this form must show name & address above. If different from the contact person, show information on signer as well. 2. Name, Address and Telephone number of Issuer: Name Address Phone 3. Please provide a brief description of terms of the transaction: (describe security and price): 08-108 (rev. 8/01) American LegalNet, Inc. www.USCourtForms.com 4. State why the buyer should qualify as an “other financial institution or institutional buyer” and discuss any of the following criteria which may be applicable: (add additional sheets as necessary) A. The expertise of the buyer’s staff and their experience in making similar purchases; B. the expertise and relevant experience of the buyer’s legal and financial representatives who are rendering independent, objective advice to the buyer concerning the proposed sale or offer; C. the similarity of the proposed sale or offer to other purchases previously made by the buyer; or D. other relevant factors. 5. Describe any special considerations the filer asks the administrator to consider, including any requests for waiver of any limitations of the exemption. Waiver requests must include full disclosure to the administrator of the facts and relevant material factors relating to the request. 6. Date sales are to begin: ___________________________ (may not begin before the effective date of the exemption as determined by the administrator) By filing this, I affirm that all statutory requirements of AS 45.55.900(b)(4) have been met to date and will continue to be met during the offering period. Signature of attorney or principal ( please describe which) Title Date E-mail address (to receive notice of effectiveness): 08-108 (rev. 8/01) American LegalNet, Inc. www.USCourtForms.com