Annual Report For Renewal Of Registration Of Securities Form. This is a Missouri form and can be use in Blue Sky Secretary Of State.
Tags: Annual Report For Renewal Of Registration Of Securities, SR-2, Missouri Secretary Of State, Blue Sky
Jason Kander Secretary of State State of Missouri Securities Division · 600 W. Main · PO Box 1276 Jefferson City, MO 65102 Annual Report for Renewal of Registration of Securities 1. Name and principal address of issuer: 2. Name, address and telephone number of correspondent: 3. Description of securities: 4. The total amount registered and sold to date in Missouri: Total amount registered _____________________________________ Total amount sold $________________________________________ 5. Have all amendments to the issuer's registration been filed with the Missouri Securities Division pursuant to Missouri regulation 15 CSR 30-52.300? _______________________________________ If not, provide the following: (a) Identify each amendment that was not provided to the Missouri Securities Division as required under Missouri regulation 15 CSR 30-52.300. (b) Provide an explanation as to why each amendment specified in 15 CSR 30-52.300 was not timely filed with the Missouri Securities Division. (c) Attach to this report all amended documents not filed with the Missouri Securities Division as identified above and set forth in 15 CSR 30-52.300. 6. Attach to this report a current prospectus marked to show changes with current financial statements. FORM SR-2 (01-05) American LegalNet, Inc. www.FormsWorkFlow.com Date___________________________________ (CORPORATE SEAL) __________________________________________________ Name of Issuer By _______________________________________________ Name and Title STATE OF _____________________________ County of ______________________________ } ss. The undersigned, __________________________________________________ , being first duly sworn, deposes and says: That he has executed the foregoing report for and on behalf of the issuer named therein, that he is _______________________ of such issuer and is fully authorized to execute and file such report; that the statements made in the report, including all attachments thereto, are not false in any material respect or misleading with respect to any material fact. __________________________________________________ Name Subscribed and sworn to before me, this _____________ day of _____________________ , 20 ______________ , _______________________________________________ Notary Public (Notary Seal) In and for the County of __________________________ State of ______________________________________ __ My Commission Expires: _________________________ _ FORM SR-2 (01-05) American LegalNet, Inc. www.FormsWorkFlow.com