Notice Of Claim Of Exemption Form. This is a New Mexico form and can be use in Securities Statewide.
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.: American LegalNet, Inc. www.USCourtForms.com 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