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Acknowledgement Of Additional Filing Requirements For Development Stage Companies Form. This is a Nevada form and can be use in Blue Sky Secretary Of State.
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Acknowledgement of
Additional Filing Requirements for Development Stage Companies
Registrations by Qualification
NAC 90.483; NAC 90.492
Issuer name (the ''Company''), file number
, is a development stage company that
has filed an application on date the Nevada Securities Division (the ''Division'') pursuant to NRS 90.490 to
register up to number shares of type of security. The Company does hereby undertake, as a
condition of registration, to comply with the additional reporting requirements of NAC 90.493 and
NAC 90.492 described below. In addition, the Company will notify the Division if the abovereferenced public offering is to extend beyond its initial offering period.
NAC 90. 483 requires that, not later than 60 days after the closing of the offering or the expiration of
the period of effectiveness, whichever occurs first, an issuer who is a development stage company
and who files a registration statement pursuant to NRS 90.490 which has been declared effective shall
file with the administrator:
1.
2.
A copy of all sales and promotional materials used in connection with the offering;
and
A report which sets forth the:
Amount of securities sold during the effective period of the offering
a)
Consideration paid for each security; and
b)
Names and addresses of all purchasers.
C)
NAC 90.492 further requires that the Issuer notify the Division of
I.
2.
3.
4.
5.
6.
Any change in the use of proceeds of the offering;
Any change in the control of the issuer;
Any merger, acquisition or reorganization;
Any change in the executive officers of the issuer;
Any change in the principal business of the issuer; or
Any other material change in the prospectus.
Such changes must be submitted to the Division in the form of a post-effective amendment that
satisfies the registration requirements of NRS Chapter 90.
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The undersigned is aware that failure by the applicant or the person filing the registration statement to
comply with the above conditions can result in the denial, suspension and revocation of the abovereferenced offering. See NRS 5 1 0 § 1 (b). Furthermore, the Division is empowered to issue an order
against the an applicant or other person, ''imposing a civil penalty of not more than $2,500 for a single
violation or $100,000 for multiple violations in a single proceeding or series of proceedings.'' See
NRS 90.630 § 2(d).
IN WITNESS WHEREOF, the parties have executed this Acknowledgement as of the date set forth
below their signatures hereto.
Issuer:
By:
Mr.
Mrs.
Ms.
, President
Attest:
Corporate Secretary
Date:
Address:
Issuer's Counsel:
By:
Mr.
Mrs.
Ms.
Date:
Address:
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