COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : (Rev. 11/98) Plaintiff(s) Calendar No. : JUDICIAL SUBPOENA FORM -against- J NOTICE OF CLAIM OF EXEMPTION : UNDER SECTION 58-13B-27J, NMSA 1978 : TO: DIRECTOR, SECURITIES DIVISION STATE OF NEW MEXICO : Defendant(s) : . .Notice .is .hereby . given. that . the. undersigned . Company .(corporation, limited partnership, limited liability ..... . ..... .... ... .. .......... ........ ...... company or limited liability partnership), claiming the exemption afforded by Section 58-13B-27J, NMSA 1978, intends to avail itself of said exemption with respect to offers and sales of its securities as hereinafter set forth. In support therefore, it submits the following information and exhibits: THE PEOPLE OF THE STATE OF NEW YORK A. GENERAL INFORMATION TO 1. Name and mailing address of Company. 2. Type of entity (corporation, limited partnership, limited liability company, limited liability partnership or other). GREETINGS: WE COMMAND YOU, that creation (incorporation, organization, filing or date ofof you attend before 3. Date and place of all business and excuses being laid aside, you and each partnership , the Honorable agreement). at the Court located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed 4. or adjourned date,Term of entity give evidence as a witness in this action on the part of the to testify and (if applicable). 5. Purpose or investment objective of business. 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 6. Address where books and records, stock certificates or capital accounts are kept and by result of your failure to comply. whom. Witness, Honorable , one of the Justices of the Name, address and telephone number of person who should be contacted about this County, day of , 20 Court in 7. B. notice. INFORMATION ABOUT THE OFFERING (Attorney must sign above and type name below) 1. Type of security, number of shares or units to be offered. 2. Offering price per share or unit. 3. Aggregate Offering Price. Attorney(s) for Office and P.O. Address 4. Name and address of, and compensation to be received by, each person who will be effecting or attempting to effect sales of securities. Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : 5. Index No. Calendar No. If monies from sales of securities are to be escrowed until a certain amount is raised, : JUDICIAL the escrow bank. attach a copy of the escrow Plaintiff(s) showing name and address of SUBPOENA agreement -against- : 6. General description of use of proceeds. 7. : General description of property, including location, in which such proceeds are to be invested. : Defendant(s) : ...................................................... 8. Is the issuer, underwriter, or their affiliates subject to the disqualifications in 12 NMAC 11.4.7.2.6.3? THE PEOPLE OF THE STATE OF NEW YORK 9. TO B. Attach a copy of the prospectus or offering memorandum describing the offering which will be utilized to offer the securities and comply with the disclosure requirements set forth in 12 NMAC 11.4.7.2.6 and attach a copy of all advertising or promotional literature. GOVERNING INSTRUMENTS GREETINGS: Attach a copy of the Articles of Incorporation, Articles of Organization, Registration of Limited Liability Partnership, Certificate of Limited Partnership or other instruments of creation of the WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Company, including all amendments. , 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 or_______________ testify and give evidence as a witness______________________________________ adjourned date, to in this action on the part of the Date Name of Company ______________________________________ 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 Signature and Title of Authorized Person sustained as a maximum penalty of $50 and all damages result of your failure to comply. Witness, Honorable Court in County, , one of the Justices of the day of , 20 ACCEPTANCE OF THIS NOTICE FOR FILING DOES NOT CONSTITUTE ANY APPROVAL OR RECOMMENDATION WHATSOEVER BY THE DIRECTOR OF THE NEW MEXICO SECURITIES DIVISION OF THE SECURITIES TO BE ISSUED OR SOLD. (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.: American LegalNet, Inc. www.USCourtForms.com