Secondary Trading Exemption Renewal Noitce Form. This is a Texas form and can be use in Blue Sky Secretary Of State.
Tags: Secondary Trading Exemption Renewal Noitce, 133.6, Texas Secretary Of State, Blue Sky
Form 133.6 Texas State Securities Board P.O. Box 13167 Austin, Texas 78711-3167 Secondary Trading Exemption Renewal Notice (Section 5.O, Texas Securities Act) FILING FEE $500.00 1. Name of Issuer: State of incorporation: Address and principal place of business: Location of books and records: Correspondent: Firm: Address: Telephone: 2. Attach all Forms 10, 10-K, 8-K, and 10-Q not previously filed with the last filing for Secondary Trading Exemption. 3. Furnish copies of latest prospectus (if any), annual report and proxy statement. 4. (a) Names and addresses of current officers and directors: Names and addresses of new officers and directors since last filing for Secondary Trading Exemption: 08-16-2010 American LegalNet, Inc. www.FormsWorkFlow.com Form 133.6 Names and addresses of any other officers and/or directors who have held office within the past 5 years, who have not been named in any prior Secondary Trading Exemption Notices: (b) Has the Issuer or any person named in Item 4(a): (1) been charged, indicted or convicted of any felony or misdemeanor of which fraud is an essential element? G No G Yes If yes, give details in an attached statement. Include identification of court, pertinent dates, style and number of case, charge, and disposition of case. (2) been subject to a permanent or temporary injunction instituted by any court? G No G Yes If yes, give details in an attached statement. Include identification of court, pertinent dates, style and number of case, charge, and disposition of case. 5. Name and address of transfer agent: 6. Attach certified financial statements of the Issuer. Such financial statements (consolidated, if applicable) shall include a balance sheet for the most recent fiscal year and the related statements of income, changes in stockholders’ equity and statements of cash flow for the 3 years ending as of the balance sheet date (or for the period of existence of the Issuer, if such period is less than 3 years). 08-16-2010 American LegalNet, Inc. www.FormsWorkFlow.com Form 133.6 7. Is there an existing over-the-counter market for the Issuer’s securities? G No G Yes If yes, the Issuer’s transfer agent must furnish the following justification of the market for the previous 12 months (excluding trades by insiders and control persons): Sales Transactions For First Quarter Ending (Date) Second Quarter Ending (Date) Third Quarter Ending (Date) Fourth Quarter Ending (Date) Number of shares Number of transactions High bid price Low bid price 8. Names and addresses of dealers making a market in the securities: 9. (a) Class(es) of security(ies) for which exemption is sought: (b) Number of shares or units eligible for secondary trading without benefit of registration under the Securities Act of 1933: 10. Include a statement from an officer of the Issuer that to the best of his or her knowledge and belief there has been no material adverse change in the financial condition of the Issuer since the date of the last audited financial statement. 08-16-2010 American LegalNet, Inc. www.FormsWorkFlow.com Form 133.6 STATE OF COUNTY OF Before me, the undersigned authority, on this day personally appeared (applicant), and having been duly sworn on oath deposes and says that the securities proposed to be sold under this exemption are not a part of an unsold allotment or subscription in the distribution of such securities by the Issuer; that securities of the same class, of the same issuer, are outstanding in the hands of the public; that no part of the proceeds of such sale will be paid directly or indirectly to the Issuer of such securities; that such sale is not directly or indirectly for the purpose of providing or furthering any scheme to violate or evade any provision of the Texas Securities Act; and that the Issuer of such securities is a going concern actually engaged in business and is neither in an organizational stage nor in receivership or bankruptcy. (Signature of Affiant) (Capacity) Subscribed and sworn to before me the _________ day of ____________________, 20 ______. Notary Public in and for the County of State of (NOTARY SEAL) My commission expires 08-16-2010 American LegalNet, Inc. www.FormsWorkFlow.com