SECURITIES REGISTRATION CHECKLIST Name of Offering:________________________________________________________________ Date of Filing _________ _____ 1. Filing fee: Examiner:________________________________________________ Amount $__________ _____ 2. Amount of securities offered:______________________________________________ _____ 3. Any adverse order, judgment or decree (copy thereof): _____ 4. Issuer information: _____ a. name _____ b. address _____ c. form of organization, state and date _____ d. general character and location of business _____ e. description of physical properties and equipment _____ f. statement of general competitive conditions in the business _____ 5. For each director and officer of the issuer: _____ a. name _____ b. address _____ c. principal occupation for the past five years _____ d. amount of securities held by each, of a date within 30 days of the filing _____ e. any material interest in any material transaction with the issuer or any significant subsidiary effected within the past three years or proposed to be effected _____ f. remuneration paid during the past 12 months and estimated to be paid during the next 12 months, directly or indirectly _____ 6. Listing of persons owning of record, or beneficially, if known, 10% or more of outstanding shares of any class of equity security of issuer: _____ a. name _____ b. address _____ c. amount of securities held, from date within 30 days of filing _____ 7. Listing of promoters (if issuer organized within past 3 years): _____ a. name _____ b. address _____ c. principal occupation for the past five years _____ d. amount of securities held by each, of a date within 30 days of the filing _____ e. any material interest in any material transaction with the issuer or any significant subsidiary effected within the past three years or proposed to be effected _____ f. remuneration paid during the past 12 months and estimated to be paid during the next 12 months, directly or indirectly _____ 8. Persons on whose behalf any part of offering is to be made in a non-issuer distribution: _____ a. name _____ b. address _____ c. amount of securities held as of the date of filing _____ d. description of any material interest in any material transaction with issuer or subsidiary effected within the past three years or proposed to be effected. _____ e. statement of reasons for non-issuer offering ____ 9. ____ Capitalization _____ a. current _____ b. pro-forma basis _____ c. description of securities outstanding or issued within past two years _____ d. amount and type of consideration received or that will be received for such issue 10. Description of securities to be offered. 1 American LegalNet, Inc. www.FormsWorkflow.com ____ 11. Offering price or method by which it will be computed. ____ 12. Estimated underwriting and selling discounts or commissions, finders fees: _____ a. if variable, how determined, maximum and minimum amounts ____ 13. Other estimated selling expenses: legal, engineering, accounting, etc. ____ 14. Underwriters (for each): _____ a. name _____ b. address ____ 15. Listing of any other recipient of a finder's fee. ____ 16. Copy of any underwriting or selling group agreement or description of proposed form of agreement. ____ 17. Description of the plan of distribution of securities which are to be offered through someone other than an underwriter. ____ 18. Estimated cash proceeds to be received by issuer from the offering: _____ a. purposes for which the proceeds are to be used _____ b. amount to be used per each purpose _____ c. order of priority in use of proceeds _____ d. amounts of any funds to be raised _____ e. amounts to purchase property, goodwill _____1. name(s) and address(es) of vendors _____2. amount paid or to be paid _____ f. names of persons who have received commissions in connection with the acquisition _____1. amount of commissions _____ g. any other expenses in connection with acquisition ____ 19. Stock options or other options outstanding: _____ a. amount _____ b. name(s) and address(es) of all such persons ____ 20. Management and other material contracts within past two years: _____ a. copy of contracts ____ 21. Description of any pending litigation or proceedings: _____ a. copy of any pending litigation or proceedings ____ 22. Copy of prospectus, pamphlets, form letters, circulars, advertisements or other sales literature. ____ 23. Specimen or copy of the security being registered. ____ 24. Copy of issuer's articles of incorporation and bylaws or equivalent. ____ 25. Copy of an indenture or other instrument covering the security to be registered. ____ 26. Written opinion of counsel as to the legality of the security being registered: _____ a. state whether the security when sold will be legally issued, fully paid and non-assessable _____ b. if a debt security, whether the security is a binding obligation of the issuer ____ 27. Written consent of any accountant, engineer, appraiser or other person whose profession gives authority to a statement made by him (if such person is named as having prepared or certified a report or valuation used in connection with the registration statement). ____ 28. Issuer's balance sheet as of a date within four months prior to filing date. ____ 29. Issuer's profit and loss statement and analysis of surplus for each of the three fiscal years preceding the date of balance sheet. 2 American LegalNet, Inc. www.FormsWorkflow.com ____ 30. Same financial statement as in No. 28 and 29 above of any business, if part of offering proceeds is to be applied to the purchase of such business. ____ 31. Escrow requirement: ________ yes ____ 32. Copy of escrow agreement, if applicable. ____ 33. Minimum amount prior to release of escrow, if applicable: ___________ Percentage of min. to max. ________% ____ 34. Other requirements: ____________________________________________________ ________ no _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _______________________________________________________________________ ____ 35. Date(s) to issuer with deficiencies: ______________________________ ______________________________ ______________________________ ______________________________ ______________________________ ______________________________ ____ 36. Date of effectiveness: ___________________________________________________ 3 American LegalNet, Inc. www.FormsWorkflow.com