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Notice Of Claim Of Exemption Form. This is a New Mexico form and can be use in Securities Statewide.
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Tags: Notice Of Claim Of Exemption, 27K, New Mexico Statewide, Securities
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
Index No.
:
(Rev. 11/98)
Plaintiff(s)
Calendar No.
:
JUDICIAL SUBPOENA
FORM
-against- K NOTICE OF CLAIM OF EXEMPTION
:
UNDER SECTION 58-13B-27K, NMSA 1978
(To be completed by non-New Mexico entities only)
:
:
TO:
DIRECTOR, SECURITIES DIVISION
Defendant(s)
:
. . . . . . . . STATE .OF .NEW MEXICO. . . . . . . . . . . . . . . . . . . . . . . . .
...... .. ...........
Notice is hereby given that the undersigned Company (corporation, limited partnership, limited liability
company or limited liability partnership) and claiming the exemption afforded by Section 58-13B-27K,
NMSA 1978, intends
THE PEOPLE OF THEto avail itself NEW YORK
STATE OF 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:
TO
I.
GENERAL INFORMATION
A.
Name and mailing address of company.
GREETINGS:
B.
Type of entity (corporation, limited partnership, limited liability company, limited liability
partnership or other).
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at the
Court
located at
County ofC.
Date and place of creation (incorporation, organization, filing or date of partnership
in room
, on the
, 20
, at
o'clock in the
noon, and at any recessed
agreement). day of
or adjourned date, to testify and give evidence as a witness in this action on the part of the
D.
Term of entity (if applicable).
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
E.
Purpose this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
the party on whose behalf or investment objective of business.
result of your failure to comply.
F.
Address where books and records, stock certificates or capital accounts are kept and by
Witness, Honorable
whom.
Court in
County,
G.
, one of the Justices of the
day of
, 20
Estimated number of persons to whom offers will be made.
(Attorney must sign above and type name below)
H.
Number of current security holders.
I.
Name and address of each person who will be effecting or attempting to effect sales of
securities.
Attorney(s) for
Office and P.O. Address
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
Index No.
:
II.
GOVERNING INSTRUMENTS
:
Plaintiff(s)
Calendar No.
JUDICIAL SUBPOENA
Attach a copy of -againstthe Articles of Incorporation, Articles :of Organization, Registration of Limited
Liability Partnership, Certificate of Limited Partnership or other instruments of creation of the
Company, including all amendments.
:
III.
:
REPRESENTATIONS
Defendant(s)
:
. . . . . . . . The.undersigned represents: . . . . . . . . . . . . . . . . . . . . . . .
... ...................
1.
That the number of security holders will not in consequence of any sale made under the
exemption afforded by Section 58-13B-27K exceed twenty five.
THE PEOPLE OF THEsales have been and will be made only to buyers believed to be purchasing for
2.
That STATE OF NEW YORK
investment.
TO
3.
GREETINGS:
4.
That no commissions or other remunerations have been, are being, or will be paid or
given, directly or indirectly, for solicit prospective buyer except to broker dealers and
sales representatives licensed pursuant to the New Mexico Securities Act of 1986.
That neither news releases, advertisements in newspapers, radio, television nor any
other form of public advertising will be used in any manner to contact prospective buyers.
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable That it understands that acceptance of this notice filing does not constitute approval or
at the
Court
5.
located at
County of
recommendation by the Director of the Securities Division of the securities to be issued
and sold.
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
6.
That the promoters and persons listed under paragraph II, above, understand the
provisions of Section 58-13B-30, New Mexico Securities Act of 1986, which states that in
connection with the offer to sell, sale, offer to purchase or purchase of a security, a
person shall not, directly or indirectly employ any a contempt of court defraud; make an
Your failure to comply with this subpoena is punishable as device, or artifice to and will make you liable to
untrue statement of a material fact where such penalty of would all misleading; or
the party on whose behalf this subpoena was issued for a maximuman omission$50 and be damages sustained as a
engage in an act, practice or course of business which operates or would operate as a
result of your failure to comply.
fraud or deceit upon a person.
Witness, Honorable
Court in
County,
_______________
Date
, one of the Justices of the
day of
, 20
______________________________________
Name of Company
(Attorney must sign above and type name below)
______________________________________
Signature and Title of Authorized Person
Attorney(s) for
Office and P.O. Address
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com