Notice Of Offices Directors Partners Control Persons Managers Memebers Trustees And Employees Of A Capital Access Co
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Notice Of Offices Directors Partners Control Persons Managers Memebers Trustees And Employees Of A Capital Access Co Form. This is a California form and can be use in Blue Sky Secretary Of State.
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Tags: Notice Of Offices Directors Partners Control Persons Managers Memebers Trustees And Employees Of A Capital Access Co, 280.153, California Secretary Of State, Blue Sky
Fee: $20.00 + DOJ Noncriminal Applicant Fingerprint Fee
(Fees should include the Department of Corporations’ filing fee of [$20.00]
and the fee charged by the Department of Justice [Penal Code Section 11105]
for processing Noncriminal Applicant Fingerprints.)
Receipt No.__________________
STATE OF CALIFORNIA
DEPARTMENT OF CORPORATIONS
NOTICE OF
OFFICERS, DIRECTORS, PARTNERS, “CONTROL” PERSONS, MANAGERS, MEMBERS,
TRUSTEES AND EMPLOYEES OF A CAPITAL ACCESS COMPANY*
OFFICIAL USE ONLY
LAST NAME
Date submitted CII:
I.D.#
Applicant
PLEASE PRINT OR TYPE
NAME OF COMPANY: __________________________________________
FILE NO. _______________
ADDRESS OF MAIN OFFICE: ___________________________________________________________________
(Street)
(City)
(State)
(Zip Code)
EMPLOYING BRANCH OFFICE: ________________________________________________________________
NAME OF OFFICER, DIRECTOR, PARTNER, “CONTROL” PERSON, MANAGER, MEMBER, TRUSTEE
AND EMPLOYEE:
________________________________________________________________________________________________________________________________________________________
(Last)
(First)
(Middle)
POSITION HELD OR TO BE HELD: _____________________________________________________________
HOME ADDRESS: ____________________________________________________________________________
(Street)
(City)
(State)
(Zip Code)
DATE OF BIRTH: __________________________ PLACE OF BIRTH: ______________________________
(Month)
(Day)
(Year)
HEIGHT: ______________ WEIGHT: ____________ SEX: __________
COLOR OF EYES: ____________
COLOR OF HAIR: ____________
*
This document shall be treated by the Department of Corporations as being received in confidence pursuant to
paragraph (4) of subdivision (d) of Section 6254 of the Government Code.
CACL 280.153
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