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Report Of Securities Sales And Use Of Proceeds Form. This is a Alaska form and can be use in Blue Sky Secretary Of State.
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Tags: Report Of Securities Sales And Use Of Proceeds, 08-112, Alaska Secretary Of State, Blue Sky
REPORT OF SECURITIES SALES AND USE OF PROCEEDS Complete and return to: Administrator of Securities Division of Banking and Securities P.O. Box 110807 Juneau, AK 99811-0807 (907) 465-6339 Alaska file number:______________________ Registrant name: Managing underwriter: (if any) Date offering commenced: Date offering completed: Total amount of securities registered: $ Amount registered in Alaska: $ Amount of securities sold in Alaska: $ Total amount received from the public: $ Use of proceeds, itemized statement: (List separately a) underwriting discounts and commissions; b) expenses paid to or for underwriters; c) other expenses of the offering paid by or for the account of the registrant; and d) other purposes for which a substantial amount of proceeds were used. For each category, list separately payments to directors, officers, and affiliates. If any proceeds were used for purposes other than in the prospectus, please state the reason for deviating. If all proceeds were used as indicated in the prospectus, please so state.) Continue on back of form 08-112 (04/14) American LegalNet, Inc. www.FormsWorkFlow.com Signature Title Date 08-112 (04/14) American LegalNet, Inc. www.FormsWorkFlow.com