STATE OF NORTH CAROLINA DEPARTMENT OF THE SECRETARY OF STATE Securities Division P.O. Box 29622 Raleigh, North Carolina 27626-0622 (919) 733-3924 APPLICATION FOR REGISTRATION/RENEWAL as a QUALIFIED BUSINESS THE MISREPRESENTATION OF ANY FACT HEREIN CONSTITUTES A VIOLATION OF LAW. (PLEASE FURNISH INFORMATION REQUESTED BELOW) Legal Name of Applicant Business: _________________________________________________________________ To the Secretary of State of North Carolina: Pursuant to the provisions of §105-163.013 of the North Carolina General Statutes, we submit the following information and certify the following facts to apply for registration of the undersigned business as a (check one of the following): QUALIFIED BUSINESS VENTURE (as defined in N.C.G.S. §105-163.010(8)); QUALIFIED GRANTEE BUSINESS (as defined in N.C.G.S. §105-163.010(9));or QUALIFIED LICENSEE BUSINESS (as defined in N.C.G.S. §105-163.010(9a)). This Application for Registration is for (check one): INITIAL REGISTRATION RENEWAL OF REGISTRATION REINSTATEMENT AFTER REVOCATION OF REGISTRATION RE-REGISTRATION AFTER REVOCATION OF REGISTRATION American LegalNet, Inc. www.FormsWorkFlow.com I. GENERAL INFORMATION (to be submitted by all applicants): 1. Name, address, telephone number, and fiscal year of Applicant Business: Legal Name: ______________________________________________________________________________ Street address: _____________________________________________________________________________ Mailing address: ____________________________________________________________________________ City, State, Zip Code: _______________________________________________________________________ Telephone number: (______) _________________________________________________________________ Fiscal year end (month and day): ______________________________________________________________ 2. Type of business organization: Proprietorship Corporation General Partnership Limited Partnership Limited Liability Company Limited Liability Partnership Attach a copy of the documents under which the Applicant Business is organized (i.e., Articles of Incorporation, Articles of Organization, Certificate of Limited Partnership, etc.) to this Application for Registration. 3. Identify the Applicant Business' Authorized Representative (see Instruction 7 for further details): Name: ___________________________________________________________________________________ Title: ____________________________________________________________________________________ Street Address: ____________________________________________________________________________ Mailing Address: ___________________________________________________________________________ City, State, Zip Code: _______________________________________________________________________ Telephone: (_____) ________________________ Facsimile: (_____) _______________________________ E-mail Address: ____________________________________________________________________________ 2 American LegalNet, Inc. www.FormsWorkFlow.com 4. If Applicant Business is a Corporation, Limited Liability Company, or Limited Partnership, set forth the date and state or country of incorporation, organization, or formation: Date: ____________________________________________________________________________________ State or Country of Formation: ______________________________________________________________ 5. Address of the Applicant Business' business headquarters if different from the address shown in Item 1: __________________________________________________________________________________________ __________________________________________________________________________________________ 6. Location of the Applicant Businesses' principal business operations: County:___________________________________________________________________________________ State or Country:___________________________________________________________________________ 7. Give a summary of the business activities in which the Applicant Business engages (attach additional pages if necessary): __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ 8. Check this item ONLY if applicable: Minority Business. The Applicant Business is at least fifty-one percent (51%) owned by one or more minority persons (as defined in N.C.G.S. §143-128.2), or in the case of a corporation, its stock is at least fiftyone percent (51%) owned by one or more minority persons. Additionally, its management and daily business operations are controlled by one or more of the minority persons who own it. 3 American LegalNet, Inc. www.FormsWorkFlow.com 9. Complete these two items ONLY if this is an application for renewal of registration as a Qualified Business or an application for reinstatement of registration following revocation. (a) Indicate the number of jobs created by the Applicant Business during the preceding year: (Please give the total number for ALL of the jobs created) ______________________________ (b) Indicate the average wages paid by these jobs (attach additional pages if necessary): (Please add all of the wages and divide by the number of jobs.) $ /annum II. HOW TO COMPLETE THE REMAINDER OF THIS FORM: QUALIFIED BUSINESS VENTURE: If the Applicant Business is applying for registration as a Qualified Business Venture, complete "Attachment A -- Qualified Business Venture" below and attach the following: (a) FINANCIAL STATEMENT. The Applicant Business must attach a CERTIFIED FINANCIAL STATEMENT (i.e., reviewed or audited by an independent certified public accountant) for its most recent fiscal year prior to the filing of such application showing revenues, as determined in accordance with generally accepted accounting principles, of five million dollars ($5,000,000) or less on a consolidated basis: (a) to its INITIAL application for registration; (b) to each application for RENEWAL of registration; and (c) to any application for RE-REGISTRATION or REINSTATEMENT of REGISTRATION after revocation of registration. However, a "start-up" business which has been organized after January 1 of the calendar year in which the initial application for registration is filed is not required to submit a financial statement with its application for registration. Also, a business which was created prior to January 1 of the year in which it submits its initial application for registration may be granted a conditional registration if it is unable to produce the required certified financial statement without undue hardship. The granting of such a registration is subject to the provisions of Subsection .1602(i) of Subchapter 6A of Title 18 of the North Carolina Administrative Code. If such a financial statement is not filed with the Division within the deadline prescribed by that rule, the conditional registration shall be canceled as of its initial effective date. A request for such a conditional registration must be made in writing, must demonstrate how the furnishing of the statement normally required would impose an undue hardship on the business, must consent to the condition set forth in the rule, and must be submitted with the application for registration. (b) BUSINESS ACTIVITY LETTER. The Applicant Business must include a “business activity” letter, in addition to the Summary of Business Activity designated on page 3 #7 of this application, signed by an authorized representative of the business, which: describes the business activities in which the Applicant Business is or will be engaged; describes how such activities meet the business activity requirements of Item (b) of Attachment A; states whether the Applicant Business is or will be engaged in any of the restricted activities listed in Item (c) of Attachment A; states the percentage of the gross revenues generated or expected to be generated by the restricted activities listed in Item (c) of Attachment A; and represents that the Applicant Business is not established as one of its primary purposes to engage in any of the restricted activities described in Item (c) of Attachment A. 4 American LegalNet, Inc. www.FormsWorkFlow.com (c) FILING FEE. The appropriate filing fee must be included with this application. (See Instruction 1 at the end of this form for the correct fee.) QUALIFIED GRANTEE BUSINESS: If the Applicant Business is registering as a Qualified Grantee Business, complete "Attachment B -- Qualified Grantee Business" and attach: (a) EVIDENCE OF FUNDING. The Applicant Business must include written evidence of the receipt of the grant, investment, or funding certified to in Attachment B of this form. This requirement may be satisfied by evidence of an agreement obligating the grantor entity to provide funds or a grant to the Applicant Business, or by evidence showing the actual receipt of such funds by the Applicant Business. The document submitted must show that the grant, investment, or funding was received or contracted for during the current year or any of the three years preceding the date of submission of the application for registration under consideration. (b) EVIDENCE OF ORGANIZATION/INSTITUTE QUALIFICATION. The Applicant Business must include written evidence (where required by Attachment B) that the organization from which the Applicant Business has received a grant or funding is either; i) a domestic/foreign corporation that is tax-exempt pursuant to section 501(c)(3) of the Code, ii) a domestic/foreign corporation that is tax-exempt pursuant to section 501(c)(3) of the Code, is a private foundation pursuant to section 509 of the Code, or is an affiliate of either of the foregoing; or iii) an institute administratively located within a constituent institution of the University of North Carolina and is financed in part by a domestic/foreign corporation that is tax-exempt pursuant to section 501(c)(3) of the Code and the institute directly or in collaboration with other entities funds small businesses engaging in developing technology. (c) EVIDENCE OF PRINCIPAL PURPOSE. The Applicant Business must include written evidence (where required by Attachment B) that the organization from which the Applicant Business has received a grant or funding has as a principal purpose the stimulation of the development of any of the following: i) the biotechnology industry; ii) conducting research and development in, or stimulating the development of, electronic, photonic, information, or other technologies, which may include investing in companies that provide research, development, products or services in these technologies; or iii) the economic development based on the advancement of science, engineering, and technology. (d) EVIDENCE OF DIRECT STATE APPROPRIATIONS. The Applicant Business must include written evidence (where required by Attachment B) that the organization from which the Applicant Business has received a grant, an investment, or funding, either; i) has received direct appropriations from the State in at least three fiscal years, or ii) is a successor in interest or to an organization that has received direct appropriations from the State in at least three fiscal years. (e) FILING FEE. The appropriate filing fee must be included with this application. See Instruction 1 at the end of this form for the correct fee. QUALIFIED LICENSEE BUSINESS: If the Applicant Business is registering as a Qualified Licensee Business, complete "Attachment C -- Qualified Licensee Business” and attach: FINANCIAL STATEMENT. The Applicant Business must attach a CERTIFIED (a) FINANCIAL STATEMENT (i.e., reviewed or audited by an independent certified public accountant) for its most recent fiscal year prior to the filing of such application showing revenues, as determined in accordance with generally accepted accounting principles, of one million dollars ($1,000,000) or less on a consolidated basis: (a) to its INITIAL application for registration; (b) to each application for RENEWAL of registration; and (c) to any application for RE-REGISTRATION or REINSTATEMENT of REGISTRATION after revocation of registration . However, a "start-up" business which has been organized after January 1 of the calendar year in which the initial application for registration is filed is not required to submit a financial statement with its 5 American LegalNet, Inc. www.FormsWorkFlow.com application for registration. Also, a business which was created prior to January 1 of the year in which it submits its initial application for registration may be granted a conditional registration if it is unable to produce the required certified financial statement without undue hardship. A request for such a conditional registration must be made in writing, must demonstrate how the furnishing of the statement normally required would impose an undue hardship on the business, must consent to the condition set forth in the rule, and must be submitted with the application for registration. (b) EVIDENCE OF CERTIFICATION BY A CONSTITUENT UNIVERSITY OF THE UNIVERSITY OF NORTH CAROLINA. The Applicant Business must include written evidence (where required by Attachment C) from a constituent institution of The University of North Carolina or a research university as currently performing under a licensing agreement with the institution or university under a licensing agreement with the institution or university for the purpose of commercializing technology developed at the institution or university. A research university is an institution of higher education classified as a Doctoral/Research University, Extensive or Intensive, in the most recent edition of “A Classification of Institutions of Higher Education”, the official report of The Carnegie Foundation for the Advancement of Teaching. (c) FILING FEE. The appropriate filing fee must be included with this application. (See Instruction 1 at the end of this form for the correct fee.) 6 American LegalNet, Inc. www.FormsWorkFlow.com III. ATTACHMENT A -- QUALIFIED BUSINESS VENTURE The Applicant certifies that the following representations are true, complete, correct, and not misleading: (a) Check one of the following: (1) the Applicant Business was organized after January 1 of the calendar year in which this application for registration is filed; or (2) during its most recent fiscal year before filing this application for registration, the Applicant Business had gross revenues, as determined in accordance with generally accepted accounting principles, of five million dollars ($5,000,000) or less on a consolidated basis; (b) the Applicant Business is organized to engage primarily in (check applicable categories): Manufacturing Processing Warehousing Wholesaling Research and Development Service-Related Industry; (c) the Applicant Business does not engage as a substantial part of its business in any of the following: providing a professional service as defined in Chapter 55B of the North Carolina General Statutes; construction or contracting; “selling or leasing at retail” (see N.C.G.S. §105-163.010(12) for the meaning of this term); the purchase, sale, or development, or purchasing, selling, or holding for investment of commercial paper, notes, other indebtedness, financial instruments, securities, or real property, or otherwise making of investments; providing personal grooming or cosmetics services; or offering any form of entertainment, amusement, recreation, or athletic or fitness activity for which an admission or a membership is charged. (d) the Applicant Business was not formed for the primary purpose of acquiring all or part of the stock or assets of one or more existing businesses; and (e) the Applicant Business is not a “real estate-related business” (see N.C.G.S. §105-163.010(10) for meaning of this term). 7 American LegalNet, Inc. www.FormsWorkFlow.com The Applicant Business agrees to notify the Securities Division of the Department of the Secretary of State of North Carolina in writing immediately of the occurrence of any of the following events (Items (f)-(g)), as applicable: (f) when the gross revenues of the Applicant Business exceed five million dollars ($5,000,000) in a fiscal year. (This notice is to be given by filing a financial statement with the Secretary of State showing the gross revenues of the business for that year.); or (g) a merger, consolidation, or other similar transaction with another business in which the surviving business meets the criteria for being a Qualified Business Venture. (In such a case, the Qualified Business Venture agrees to provide the Secretary of State with written notice of such transaction and the name, address, and jurisdiction of incorporation of the surviving company.) UNDER PENALTIES PRESCRIBED BY LAW, I CERTIFY AND AFFIRM THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THIS APPLICATION IS TRUE AND COMPLETE. ___________________________________________________________ Name of Applicant Business by: ____________________________________________________________ Signature of Authorized Representative _______________________________________________________ Print Name of Authorized Representative _______________________________________________________ Title of Authorized Representative _______________________________________________________ Date (If the applicant is a corporation, this application shall be signed by one of the following: President, Vice-President, Secretary or Treasurer.) 8 American LegalNet, Inc. www.FormsWorkFlow.com IV. ATTACHMENT B -- QUALIFIED GRANTEE BUSINESS The Applicant certifies that the following representation is true, complete, correct, and not misleading: The Applicant Business has attached and/or submitted evidence of one of the following (check one): Proof of grant, investment, or funding received during the current year or within the previous three years from a federal agency under the Small Business Innovation Research program (administered by the U.S. Small Business Administration). Proof of grant, investment, or funding received during the current year or within the previous three years from an organization that meets all of the following qualifications: A) the organization is a domestic or foreign corporation, B) the organization is tax-exempt pursuant to section 501(c)(3) of the Code, C) the organization has a principal purpose the stimulation of the development of the biotechnology industry, and D) in furtherance of that purpose, either, i) the organization has received direct appropriations from the State in at least three fiscal years, or ii) is a successor in interest to an organization that has received direct appropriations from the State in at least three fiscal years. Proof of grant or funding received within the previous three years from an organization that meets all of the following qualifications: A) the organization is a domestic or foreign corporation, B) the organization is tax-exempt pursuant to section 501(c)(3) of the Code, is a private foundation pursuant to section 509 of the Code, or is an affiliate of either of the foregoing, C) the organization has as its principal purpose one of the following: conducting research and development in, or stimulating the development of electronic, photonic, information, or other technologies, which may include investing in companies that provide research, development, products or services in these technologies, D) in furtherance of that purpose, either, i) the organization has received direct appropriations from the State in at least three fiscal years, or ii) the organization was organized to perform one of these purposes for an organization that has received direct appropriations from the State in at least three fiscal years, or iii) the organization is an affiliate of an entity that is an organization that was organized to perform one of these purposes for an organization that has received direct appropriations from the State in at least three fiscal years. Proof of grant or funding received within the previous three years from an organization that meets all of the following qualifications: A) the organization is an institute, B) the organization is administratively located within a constituent institution of the University of North Carolina, C) the organization is financed in part by a domestic or foreign corporation that is tax-exempt pursuant to section 501(c)(3) of the Code, D) the organization has as a principal purpose the stimulation of economic development based on the advancement of science, engineering, and technology, and 9 American LegalNet, Inc. www.FormsWorkFlow.com E) the organization funds, either directly or in collaboration with other entities, small businesses engaging in developing technology. The Applicant Business agrees to notify the Securities Division of the Department of the Secretary of State of North Carolina in writing immediately of the occurrence of a merger, consolidation, or other similar transaction with another business in which the surviving business meets the criteria for being a Qualified Grantee Business. In such a case, the Qualified Grantee Business agrees to provide the Secretary of State with written notice of such transaction and the name, address, and jurisdiction of incorporation of the surviving company. UNDER PENALTIES PRESCRIBED BY LAW, I CERTIFY AND AFFIRM THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THIS APPLICATION IS TRUE AND COMPLETE. _______________________________________________________ Name of Applicant Business by: ______________________________________________________ Signature of Authorized Representative _______________________________________________________ Print Name of Authorized Representative _______________________________________________________ Title of Authorized Representative _______________________________________________________ Date (If the applicant is a corporation, this application shall be signed by one of the following: President, Vice-President, Secretary or Treasurer.) 10 American LegalNet, Inc. www.FormsWorkFlow.com V. ATTACHMENT C -- QUALIFIED LICENSEE BUSINESS The Applicant certifies that the following representations are true, complete, correct, and not misleading. The Applicant Business has also attached and/or submitted evidence for each of the following:: (a) During its most recent fiscal year before filing this application for registration, the Applicant Business had gross revenues, as determined in accordance with generally accepted accounting principles, of one million dollars ($1,000,000) or less on a consolidated basis; and (b) It has been certified by a constituent institution of The University of North Carolina or a research university as currently performing under a licensing agreement with the institution or university for the purpose of commercializing technology developed at the institution or university. The Applicant Business agrees to notify the Securities Division of the Department of the Secretary of State of North Carolina in writing immediately of the occurrence of any of the following events (Items (c)-(d)), as applicable: (c) when the gross revenues of the Applicant Business exceed one million dollars ($1,000,000) in a fiscal year. (This notice is to be given by filing a financial statement with the Secretary of State showing the gross revenues of the business for that year.); or (d) a merger, consolidation, or other similar transaction with another business in which the surviving business meets the criteria for being a Qualified Licensee Business. (In such a case, the Qualified Licensee Business agrees to provide the Secretary of State with written notice of such transaction and the name, address, and jurisdiction of incorporation of the surviving company.) UNDER PENALTIES PRESCRIBED BY LAW, I CERTIFY AND AFFIRM THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THIS APPLICATION IS TRUE AND COMPLETE. ___________________________________________________________ Name of Applicant Business by: ____________________________________________________________ Signature of Authorized Representative _______________________________________________________ Print Name of Authorized Representative _______________________________________________________ Title of Authorized Representative _______________________________________________________ Date (If the applicant is a corporation, this application shall be signed by one of the following: President, Vice-President, Secretary or Treasurer.) 11 American LegalNet, Inc. www.FormsWorkFlow.com VI. GENERAL INSTRUCTIONS QUALIFIED BUSINESS REGISTRATION 1. FILING FEES. a. The filing fee required for an INITIAL application for registration as a Qualified Business is One Hundred Dollars ($100.00). b. The filing fee required for a RENEWAL application for a Qualified Business is Fifty Dollars ($50.00). c. The filing fees required for a REINSTATEMENT AFTER REVOCATION OF REGISTRATION are (1) a $50.00 filing fee and (2) a $1,000.00 penalty (for a total of $1,050.00). d. The filing fees required for a RENEWAL OF REGISTRATION AFTER REVOCATION OF REGISTRATION are (1) a $100.00 filing fee and (2) a $1,000 penalty (for a total of $1,100.00). e. The filing fee shall be payable by check made payable to the order of "N.C. SECRETARY OF STATE". Such filing fee shall accompany the application for registration. 2. EFFECTIVE DATES OF FILING: a. The effective date of registration for a Qualified Business Venture whose application is accepted for registration is 60 days before the date its application was filed. The effective date of registration for a Qualified Grantee Business or a Qualified Licensee Business whose application is accepted for registration is the date its application is filed. No tax credit will be allowed for an investment made before the effective date of the registration or after the registration is revoked. b. A registration is effective until the deadline for renewal, unless revoked by the Securities Division. c. Each RENEWAL application for registration shall be filed ANNUALLY, no later than the FIFTEENTH (15th) day of the THIRD (3rd) month following the close of the business' fiscal year. CAUTION! This deadline for filing of application for renewal of registration may require the Applicant Business to file such application for renewal before a full year has elapsed since the date of filing of the initial application for registration. d. The date of filing of all applications for registration (both initial and renewals) shall be recorded at the time of receipt by the Securities Division and shall not be construed to be the date of mailing. 12 American LegalNet, Inc. www.FormsWorkFlow.com 3. WHERE TO FILE APPLICATIONS FOR REGISTRATION: All applications for registration shall be filed by mailing the application, together with any supplemental schedules or statements and the appropriate fees, by courier or by regular mail, to: The Department of the Secretary of State Securities Division Qualified Business Registration P.O. Box 29622 Raleigh, NC 27626-0622 (919) 733-3924 or For Walk-ins and Hand Deliveries ONLY The Department of the Secretary of State Securities Division 2 South Salisbury Street Raleigh , North Carolina 27601-2903 NOTE: The date of filing of all applications for registration (both initial and renewals) shall be recorded at the time of receipt by the Securities Division and shall not be construed to be the date of mailing. 4. RENEWAL OF REGISTRATION: a. In order to continue to remain qualified as either a Qualified Business Venture, a Qualified Grantee Business, or a Qualified Licensee Business following its initial registration period, a business is required to renew its registration annually. Such renewal is accomplished by the filing of an application for registration, with the appropriate items checked to indicate that such application is a renewal of a prior registration, accompanied by the appropriate filing fee (see Instruction 1), by the filing due date (see Instruction 2). b. Each renewal application for registration of a Qualified Business Venture or a Qualified Licensee Business must be accompanied by a certified financial statement for the business' most recent fiscal year. 5. FAILURE TO RENEW REGISTRATION BY RENEWAL DEADLINE; REVOCATION, REINSTATEMENT, AND RE-REGISTRATION: a. Failure to Renew. The failure of a registered business to renew its registration annually as described in Instructions 2 and 4 will not result in the forfeiture of tax credits previously allowed to taxpayers who invested in the business. (Such forfeitures, however, will occur where those situations described in N.C.G.S. §105163.014 exist (e.g., participation in the operation of the business, filing of a false application, or transfer or redemption of the taxpayer's investment)). However, if the business wishes to attract new investors by holding out the possibility of a tax credit based on their investments, it should maintain a continuous registration, without allowing that registration to lapse. b. Revocation: If the Qualified Business fails to renew its registration by the deadline specified in Instruction 2 above, the registration shall be revoked effective as of the next day following the renewal deadline. In such a case, the Secretary of State is required to send the Qualified Business a notice of revocation within 60 days after the renewal deadline. 13 American LegalNet, Inc. www.FormsWorkFlow.com c. Reinstatement: The business can reinstate its registration after a failure to meet the deadline for renewal by filing an application for reinstatement with the Secretary of State within 30 days after receipt of the notice of revocation. This application must be accompanied by (i) a $50.00 reinstatement fee and (ii) a $1,000.00 late filing penalty. An application for reinstatement is done by check the blank for "REINSTATEMENT AFTER REVOCATION OF REGISTRATION' on the first page of this application for registration form, filling in the information required by the form, attaching any supplemental information required by the form, and filing this application package, along with the fees, with the Securities Division of the Department of the Secretary of State. A registration that is reinstated properly will be treated as if it had not been revoked; that is, the business will be considered to have been continuously registered, without any lapse in registration. However, to be reinstated, the business must file its application for reinstatement within the 30-day period specified in the preceding paragraph. d. Re-Registration: A business is permitted to apply for a new registration after revocation of its original registration and its failure to reinstate that registration within the deadline for reinstatement. Such a "reregistration" is accomplished by checking the blank for "RE-REGISTRATION AFTER REVOCATION OF REGISTRATION" on the first page of this application for registration form, filling in the information required by the form, attaching any required supplemental information and filing the re-registration package, along with the required fees, with the Securities Division. The fees for an application for re-registration are (i) a $100.00 filing fee and (ii) a $1,000.00 late penalty. A re-registration, if approved, will be effective as of the date the application for re-registration is filed. In this situation, there will be a lapse in the registration of the business following the deadline for renewal of registration and extending to the effective date of the re-registration. 6. FILING OF NOTICE OF TERMINATION OF QUALIFIED BUSINESS VENTURE STATUS OR A QUALIFIED LICENSEE BUSINESS: If the revenues of a Qualified Business Venture exceed five million dollars ($5,000,000) in the current fiscal year, the business must notify the Secretary of State in writing of this fact by filing a financial statement showing the gross revenues of the business for that year. If the revenues of a Qualified Licensee Business exceed one million dollars ($1,000,000) in the current fiscal year, the business must notify the Secretary of State in writing of this fact by filing a financial statement showing the gross revenues of the business for that year. 7. AUTHORIZED REPRESENTATIVE: The "authorized representative" of a business applying for registration is the person who is authorized by the business to complete and file an application for registration on behalf of the Applicant Business. If the business is a corporation, the Authorized Representative must be its President, Vice-President, Secretary, or Treasurer. The "authorized representative" is the person whom the Securities Division will contact if questions arise relating to the registration of the Applicant Business. Because tax credits are allowable only with respect to investments made while the business maintains an effective registration, and because the "authorized representative" may be responsible for maintaining the effectiveness of the registration, this person should be chosen carefully. (REVISED 06/16/09) 14 American LegalNet, Inc. www.FormsWorkFlow.com