COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : (Rev. 11/98) TO: Index No. Calendar No. : JUDICIAL Plaintiff(s) FORM 27-U NOTICE OF CLAIM OF EXEMPTION UNDER SECTION 58-13B-27U, NMSA 1978 -against: SUBPOENA : DIRECTOR, SECURITIES DIVISION STATE OF NEW MEXICO : Notice is hereby given that the undersigned Company (corporation, limited partnership, limited liability Defendant(s) : . .company .or. limited. . . . . . . .partnership) . and . claiming. . . . .exemption afforded by Section 58-13B-27U, . . . . . . . . . . . . . liability . . . . . . . . . . . . . . . . . . the . . . . 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: I. GENERAL INFORMATION THE PEOPLE OF THE STATE OF NEW YORK A. Name and mailing address of Company. B. Type of entity (corporation, limited partnership, limited liability company, limited liability partnership or other). TO GREETINGS: C. Date and place of creation (incorporation, organization, filing or date of partnership E. Purpose or investment objective of business. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before agreement). , the Honorable at the Court located at County of Termthe entity (if applicable). in room D. , on of 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 Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to F. Address this subpoena was issued stock certificates or capital accounts are kept and by the party on whose behalf where books and records,for a maximum penalty of $50 and all damages sustained as a whom. result of your failure to comply. II. Court in LIMITATION ON NUMBER OF PURCHASERS Witness, Honorable County, day of , one of the Justices of the , 20 A. Estimated number of persons to whom offers will be made in the State of New Mexico. B. Number of current security holders in the State of Newmust sign above and type name below) (Attorney Mexico. C. Date(s) securities acquired by security holders in the State of New Mexico. Attorney(s) for D. Total number of securities holders in and out of State of New Mexico. E. Date of issuer’s last sale of securities. 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. : III. INFORMATION ABOUT OFFERING Plaintiff(s) A. Calendar No. : JUDICIAL SUBPOENA Name and address of each person who will be :effecting or attempting to effect sales of -againstsecurities. : : Defendant(s) : ...................................................... B. Aggregate amount of offering. C. Type of security (circle one). THE PEOPLE OF THE STATE OF NEW YORK Debt TO Equity: D. Common Preferred Partnership Interests Membership Interests Minimum investment that will be accepted from any individual ____________________. GREETINGS: IV. GOVERNING INSTRUMENTS WE COMMAND YOU, that all business and excuses being Organization, Registration of Limited before Attach a copy of the Articles of Incorporation, Articles of laid aside, you and each of you attend , the Honorable at Partnership or other instruments of creation of the Court Liability Partnership, Certificate of Limited the located at County ofCompany, including all amendments. in room , on the day of , 20 , at o'clock in the noon, and at any recessed REPRESENTATIONS. orV. adjourned date, to testify and give evidence as a witness in this action on the part of the The undersigned represents that: 1. The number of security punishable as State of New Mexico will not in Your failure to comply with this subpoena isholders in thea contempt of court and will make you liable to the party on whose behalfconsequence ofwas issued for aunder the exemption afforded by Section 58-13Bthis subpoena any sale made maximum penalty of $50 and all damages sustained as a 27U exceed ten (10) during any twelve consecutive months. result of your failure to comply. 2. Either: (check one box) Witness, Honorable Court in County, , one of the Justices of the a. day of Sales have been and will be made only to buyers believed to be , 20 purchasing for investment; or b. The issuer reasonably believes that the securities of the issuer will be held by fifty or fewer investors following the offering and (Attorney must sign above and type name below) the aggregate offering does not exceed five hundred thousand dollars ($500,000) during any twelve consecutive months. 3. That neither news releases, advertisements in newspapers, radio, television nor Attorney(s) for any other form of public advertising will be used in any manner to contact prospective buyers. 4. That no commissions or other remunerations have been, are being, or will be paid or given, directly or indirectly, for soliciting prospective buyers except to Office and P.O. Address broker dealers and sales representatives licensed pursuant to the New Mexico Securities Act of 1986. Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : 5. Index No. Calendar No. That it understands that acceptance of this notice filing does not constitute : Plaintiff(s) approval or recommendation by the Director JUDICIAL SUBPOENAthe of the Securities Division of securities to be issued and sold. -against: 6. That the promoters and persons listed under paragraph IIIA, 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 device, or artifice to defraud; make an untrue statement of a material fact where such an Defendant(s) : . . . . . . . . . . . . . . . . . . . . . omission. . . . . . . be . . . . . . . . . . . .or . engage in an act, practice or course of . . . . . . . would . . misleading; . . . . business which operates or would operate as a fraud or deceit upon a person. THE PEOPLE OF THE STATE OF NEW YORK _______________ Date ______________________________________ Name of Company TO ______________________________________ Signature and Title of Authorized Person GREETINGS: 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 of 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 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 result of your failure to comply. Witness, Honorable Court in County, , one of the Justices of the day of , 20 (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