Solicitation Of Interest Form. This is a Nevada form and can be use in Blue Sky Secretary Of State.
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Solicitation of Interest Form NAC 90.538 State of Nevada BARBARA K. CEGAVSKE Secretary of State Phone (702) 486-2440 Fax (702) 486-2452 Website: www.nvsos.gov PAGE 1 ABOVE SPACE FOR OFFICE USE ONLY Name of Issuer: Address of Principal Office: Street Address City State Zip Code Issuer Phone Number: Amount of Proposed Offering: Date of Organization: Name of Chief Executive Officer: THIS IS A SOLICITATION ONLY: lNo money or other consideration is being solicited and none will be accepted.lNo sale of the securities will be made or commitment to purchase accepted until the deliveryof a final offering circular that includes complete information about the issuer and the offering.lAn indication of interest made by a prospective investor involves no obligation or commitmentof any kind.lThis offer is being made pursuant to an exemption from registration under the federal and statesecurities laws. No sale may be made until the securities are registered or exempt in the stateof Nevada.lNeither federal nor state authorities have confirmed the accuracy or determined the adequacyof this document or any other document presented to you in connection with this Solicitationof Interest.THIS COMPANY: Has never conducted business operations. Is in the development stages. Is currently conducting operations. Has shown a profit for the last fiscal year. Other (specify) 1.Describe in general what business the company does or proposes to do, including what products or goods areor will be produced or services that are or will be rendered*: BUSINESS 2.Describe in general how these products or services are to be produced or rendered and how and when thecompany intends to carry out its activities*: *If additional space is needed, please attach page to this form.Nevada Secretary of State Solicitation of Interest Form Page 1 of 2Revised: American LegalNet, Inc. www.FormsWorkFlow.com Solicitation of Interest Form NAC 90.538 State of Nevada Website: www.nvsos.gov PAGE 2 ABOVE SPACE FOR OFFICE USE ONLY OFFERING PROCEEDS 3.Describe in general how the company intends to use the proceeds of the proposed offering*: KEY PERSONNEL OF THE COMPANY 4.Provide the following information for all officers and directors or persons occupying similar positions*:a)Nameb)Titlec)Telephone Numberd)Office Street Addresse)Employment Historyf)Employers: title and dates of positions held during the past 5 years g) Education: degrees, schools and dates NOTE TO USERS: This form sets forth the minimum information required for soliciting indications of interest under federal and state securities laws. You may include additional information if you think it necessary or desirable. Remember that any discussion in the document is subject to the anti-fraud provisions of the federal and state securities laws and must thereby be complete. Also, any discussion of potential rewards of the proposed investment must be balanced by the discussion of the possible risks. You may alter the graphic presentation of this form in any was as long as the minimum information is clearly presented. *If additional space is needed, please attach page to this form.Nevada Secretary of State Solicitation of Interest Form Page 2 of 2 Revised: American LegalNet, Inc. www.FormsWorkFlow.com