(Department of Corporations use only) Fee Paid $ _____________________________ DEPARTMENT OFCORPORATIONS FILE NO. ________________________________ Receipt No._____________________________ (Insert file number of previous filing of issuer before the Department, if any.) Effective Date___________________________ Date of Application:________________ FEE: $100.00 DEPARTMENT OF CORPORATIONS STATE OF CALIFORNIA FACING PAGE FOR QUALIFICATION OF NONISSUER TRANSACTION BY NOTIFICATION COURT COUNTY .OF. . . .NOTE: .Indicate .the .type . . . . . . .by. checking .the appropriate original or ......... .. . . . . . . . . . . . . . . . . of filing . . . . . . . . . . : amendment application heading shown below. No. Index : [ ] Calendar No. APPLICATION FOR QUALIFICATION OF SECURITIES UNDER SECTION 25131 OF THE CORPORATE SECURITIES LAW OF 1968 : JUDICIAL SUBPOENA Plaintiff(s) [ ] AMENDMENT NUMBER_______TO APPLICATION DATED______________________ -against: (Check and complete if applicable) 1. : Name of Issuer___________________________________________________________ 2. (a) Address of principal executive office of issuer. : Defendant(s) _______________________________________________________________________ : . . . . . . . . . . . . . . . . . . Number.and . . . . . . . . . . . . . . . . City . . . . . . . . . . . . . . . . Street ... State Zip code (b) Is the principal location of applicant’s books and records at the address of the principal executive office, above? (Indicate “yes” or “no”) if “no” provide address: THE PEOPLE OF THE STATE OF NEW YORK _______________________________________________________________________ Number and Street City State Zip code TO 3. Name and address of applicant if any other than the issuer. _______________________________________________________________________ GREETINGS: 4. Name and address of person to whom correspondence regarding this application should WE be addressed.YOU, that all business and excuses being laid aside, you and each of you attend before COMMAND , the Honorable at the Court _______________________________________________________________________ located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed 5. State whether issuer is a corporation, partnership, trust or or adjourned date, to testify and give evidence as a witness in this actionother entity and the State of on the part of the incorporation or jurisdiction under which organized. _______________________________________________________________________ 6. Your failure to comply with thiseach class is punishablebeingcontempt of court and will make you liable to Title and CUSIP number of subpoena or securities as a qualified, e.g., $10 par value the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a common stock, CUSIP 123. result of your failure to comply. _______________________________________________________________________ Witness, Honorable , one of the Justices of the (Instructions: All of the foregoing information should appear on and be the only information Court appearing on theCounty,page of theof in day application.) , 20 facing INSTRUCTIONS (Attorney must sign above and type name below) Completion of Application. The application should continue in the number sequence shown below. Any item which is inapplicable should be listed by the number on the form, followed by the word “inapplicable.” Attorney(s) for 7. Describe the business done by the issuer and its subsidiaries and the general development of such business during the last three years and indicate the intended development of the business in the immediate future. Indicate any other names under which the issuer or any of its subsidiaries have conducted business during such period. 8. List the names and home addresses of all the directors and officers of the issuer, indicating all positions and offices held by each person named. In addition, describe any order, judgment, or decree of any governmental agency or administrator, or of any court of competent jurisdiction, revoking or suspending for cause any license, permit or other Telephone No.: authority of such person or any corporation of which he is anNo.: or director, to engage Facsimile officer Office and P.O. Address E-Mail Address: Mobile Tel. No.: 260.131 (Rev 9/02) 1 American LegalNet, Inc. www.USCourtForms.com in the securities business or in the sale of a particular security or temporarily or permanently restraining or enjoining any such person or any corporation of which he is an officer or director from engaging in or continuing any conduct, practice, or employment in connection with the purchase or sale of securities, or convicting such person of any felony or misdemeanor involving a security or any aspect of the securities business or of theft or of any felony. 9. Furnish in tabular form information as to the direct remuneration paid by the issuer and its subsidiaries during the issuer’s last fiscal year for service in all capacities to each director, officer, and principal holder of securities (as defined in item 11) whose aggregate direct remuneration during such year exceeded $60,000, and the aggregate remuneration paid to all officers, directors, and principal holders of securities as a group. 10. State in tabular form the title and amount of securities called for by any options, warrants or rights, including the purchase price of the securities so called for and the expiration COURT dates of such COUNTY .OF. . . . . . . . . . .options. together. with.the.market. value .of the securities so called for as of . . . . . . . . . . .the latest practicable date.. .Such. statements .should include the foregoing information for ..... ... . . . .. .... .... : Index No. all options held by each officer or director of the issuer. Except for information required with respect to each officer or director, information with respect to option prices and : expiration dates may be furnished in ranges. Calendar No. 11. A. State in tabular form the voting securities of the issuer owned of record or beneficially : JUDICIAL SUBPOENA Plaintiff(s) by each person who owns of record or is known by the applicant to own beneficially more than 10% of the outstanding securities of any class of such voting securities. Such -against: statements should reflect the respective amounts and percentage owned either beneficially or of record by each person and such statement should also include : information as to the amounts held by, and the term of, any voting trust or similar agreement with respect to more than 10% of the outstanding securities of any class of : voting securities of the issuer. Defendant(s) B. As to each such principal security holder and each officer or director of the issuer who : . . . . . . . . . . . .effected . . . . . than. five transactions .in .the .securities .of the issuer within the last twelve . . . . . . more . . . . . . . . . . . . . . . . . . . . . . . . . . months, state the dates of all purchases and sales of securities of the issuer by such person, the prices received or paid and the number of securities bought or sold in each transaction. THE PEOPLE OF THE STATE OF NEW YORK 12. Describe any material transactions or agreements during the 3-year period immediately preceding the filing of the application between (i) the issuer or any of its affiliated companies, and (ii) any of their promoters, officers, directors, principal employees, principal security holders, underwriters or agents or any company directly or indirectly controlled by any such person or persons. Include a detailed statement of the number of promotional shares (as defined in Section 260.140.30 of Title 10 of the California Code of GREETINGS: Regulations) issued, the consideration for and any restrictions on such shares. If securities were issued by the issuer during such period, briefly describe each such WE transaction, includingthat all business and excuses being laidsecurities effected byof you attend before COMMAND YOU, any sale or distribution of the issuer’s aside, you and each or , the Honorablethrough a subsidiary of the issuer. at the Court TO located at County of 13. If the, issuer has outstanding securities 20 in room on the day of , other than common stock,in the briefly the at any recessed , at o'clock outline noon, and rights, preferences, privileges and restrictions in this action on the part of any class of of or on such securities. If the or adjourned date, to testify and give evidence as a witness outstanding common stock is nonvoting, assessable, redeemable, or subject to preemptive, rights or restrictions on transfer, outline briefly such provisions. Outline briefly the rights, term and provisions of any debt security or any other security identified in Item 6. Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a 14. Exhibits. Attach and incorporate by reference the following exhibits: result of your failure to comply. (NOTE: Any exhibit which is inapplicable should be listed by letter on the application followed simply Witness, Honorableby the word “inapplicable.”) Court in County, day of , 20 , one of the Justices of the A. Financial Statements: With respect to the issuer, the financial statements required by Section 260.613 of Title 10 of the California Code of Regulations. B. All press or publicity releases, communications to shareholders and and type name below) (Attorney must sign above communications to broker-dealers and investment advisors within the preceding twelve months by the issuer or its subsidiaries and relating to the business or intended business or to the assets or acquisitions of the issuer or its subsidiaries. Attorney(s) for C. Copy of any management contract or bonus plan, contact or arrangement with any officer or director named in item 9 above. D. The Consent to Service of Process if required by Section 25165 of the California Corporations Code. Office and P.O. Address 15. The following statement should be made and completed: There has not been and there is no adverse order, judgment or decree entered in connection with the offering or trading of Telephone court securities of the issuer by any State regulatory authority, any No.: or the Securities and Exchange Commission, except as follows: (if none, so state)No.: Facsimile E-Mail Address: Mobile Tel. No.: 260.131 (Rev 9/02) 2 American LegalNet, Inc. www.USCourtForms.com 16. The following undertaking should be made by the issuer named in Item 1 above and, if the issuer is not the applicant, executed by an authorized officer of the issuer on its behalf: The issuer, if it is the applicant, hereby undertakes to furnish the Commissioner promptly copies of all current, quarterly, semi-annual or annual reports or other material information concerning its operations furnished to its shareholders during the period a security is qualified pursuant to this application. (NOTE: The application must be signed and verified in the following manner.) The applicant has duly caused this application to be signed on its behalf by the undersigned, thereunto duly authorized. COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. _____________________________________________ (Applicant) : Calendar No. By___________________________________________ : Plaintiff(s) JUDICIAL SUBPOENA _____________________________________________ : (Title) -against- : I certify (or declare) under penalty of perjury under the laws of the State of California that I have read this application and the exhibits thereto and know the contents thereof, and that the : statements therein are true and correct. Defendant(s) Executed at______________________________________on_____________________, 20___ : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Place). . . . . . . . . . . . . . . . . . ..... (Date) ________________________________ (Signature) THE PEOPLE OF THE STATE OF NEW YORK TO Form of Application. The application should be typewritten or written in the English language, on one side only of either legal or letter-size paper. Signing of Applications. Application should be signed by an officer or general partner of the applicant; however, it may be signed by another person holding a power of attorney for such GREETINGS: purposes from the applicant, and if signed on behalf of the applicant pursuant to such power of attorney, should include as an additional exhibit a copy of said power of attorney or a copy of the WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before corporate resolution authorizing the attorney to act. , the Honorable at the Court located In County of Incorporation by Reference. at lieu of answering any specific item in this form, an applicant may on the to any in the in room , incorporate the information called for by, reference o'clockattached document, or at any recessed day of , 20 at noon, and to any document currently on givewith the Department. Such reference should indicate the pages or file evidence as a witness in this action on the part of the or adjourned date, to testify and portion of the document where the information is located. Amendments to Applications. An amendment to any application for qualification should contain only the informationwith this subpoena is punishable as a contempt of court in the form Your failure to comply being amended by item number and should be verified and will make you liable to prescribed for the application. Each amendment should be accompanied by a facing page in the the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a form prescribed by Section 260.131 of the rules on which the applicant shall insert the fact that result theyour failureamendment and the number of the amendment. of filing is an to comply. Witness, Honorable Court in County, , one of the Justices of the day of , 20 (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: 260.131 (Rev 9/02) 3 American LegalNet, Inc. www.USCourtForms.com