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Solicitation Of Interest Form (3 AAC 08.087) Form. This is a Alaska form and can be use in Blue Sky Secretary Of State.
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Tags: Solicitation Of Interest Form (3 AAC 08.087), 08-113, Alaska Secretary Of State, Blue Sky
Solicitation of Interest Form (3 AAC 08.087)
TO:
Administrator of Securities
Division of Banking, Securities & Corporations
P O Box 110807, Juneau, AK 99811-0807
Name of Company
Street Address of Principal Office
Company Telephone Number
Date of Organization
Amount of the Proposed Offering
Name of Chief Executive Officer
E-mail address of company
Ÿ
This is a solicitation of interest only. No money or other consideration is being solicited and
none will be accepted.
Ÿ No sales of the securities will be made or commitment to purchase accepted until the delivery of
a final offering circular that includes complete information about the company and the offering.
Ÿ
An indication of interest made by a prospective investor involves no obligation or commitment of
any kind.
Ÿ This offer is being made under the requirements of federal and state securities laws. Neither the
federal nor the state authorities have confirmed the accuracy or determined the adequacy of this
document or any other document presented to you in connection with this offer. No sale may be
made until the offering statement is qualified by the US Securities & Exchange Commission and the
securities are registered in Alaska.
Ÿ
Registration of the securities for sale in Alaska is dependent on compliance with the Alaska
Securities Act (AS 45.55). Therefore, there can be no assurance that the securities will be
registered for sale in Alaska.
This Company:
Has never conducted operations.
[ ]
Is in the development stages.
[ ]
Is currently conducting operations.
[ ]
Has shown a profit in the last fiscal year.
[ ]
08-113 (12/00)
[ ]
Other (specify)
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Solicitation of Interest Form (3 AAC 08.087)
A. BUSINESS
1. Describe in general what business the company does and proposes to do, including what products
or goods are or will be produced or services that are or will be rendered.
2.
Describe in general how these products or services are to be produced or rendered, and how and
when the company intends to carry out its activities.
B. OFFERING PROCEEDS
3. Describe in general how the company intends to use the proceeds of the proposed offering.
Approximate
Amounts
Description
Percentage
of Total
%
%
%
%
%
%
%
Other information you wish the Administrator to consider:
08-113 (12/00)
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Solicitation of Interest Form (3 AAC 08.087)
C. KEY PERSONNEL OF THE COMPANY
4. Provide the following information for all officers and directors (attach additional pages as needed).
Name
Title
Office Street Address
Telephone Number
Employment History for the Past Five Years
Employers
Titles
Dates of Positions (Mon/Yr)
From
To
From
To
From
To
From
To
Education
Schools/Colleges
Degrees or Certifications
Dates of Attendance (Mon/Yr)
From
From
To
Title
Office Street Address
To
From
Name
To
Telephone Number
Employment History for the Past Five Years
Employers
Titles
Dates of Positions (Mon/Yr)
From
To
From
To
From
To
From
To
Education
Schools/Colleges
Degrees or Certifications
Dates of Attendance (Mon/Yr)
From
From
To
From
08-113 (12/00)
To
To
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Solicitation of Interest Form (3 AAC 08.087)
Name
Title
Office Street Address
Telephone Number
Employment History for the Past Five Years
Employers
Titles
Dates of Positions (Mon/Yr)
From
To
From
To
From
To
From
To
Education
Schools/Colleges
Degrees or Certifications
Dates of Attendance (Mon/Yr)
From
From
To
Title
Office Street Address
To
From
Name
To
Telephone Number
Employment History for the Past Five Years
Employers
Titles
Dates of Positions (Mon/Yr)
From
To
From
To
From
To
From
To
Education
Schools/Colleges
Degrees or Certifications
Dates of Attendance (Mon/Yr)
From
To
From
To
From
To
Use additional sheets if necessary.
THIS FORM MUST BE SUBMITTED AT LEAST 10 BUSINESS DAYS PRIOR TO
THE INITIAL SOLICITATION OF INTEREST UNDER 3 AAC 08.087 ALONG WITH
ANY OTHER MATERIALS TO BE USED TO CONDUCT SOLICITATIONS OF
INTEREST. ANY AMENDMENT TO THE MATERIALS MUST COMPLY WITH
3 AAC 08.087(d).
08-113 (12/00)
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