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Application For Coordinated State Review (CR-EQUITY-1) Form. This is a Virginia form and can be use in Blue Sky Secretary Of State.
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APPLICATION FOR COORDINATED STATE REVIEW
(CR-EQUITY-1)
The Applicant requests that this filing be processed as a Coordinated State Review filing.
Please note Coordinated Review-EQUITY (CR-EQUITY) generally is intended only for initial public
offerings of common stock, preferred stock, warrants, rights and units comprised of equity securities
that also are seeking registration under Section 5 of the Securities Act of 1933. CR-EQUITY is not
available for Regulation A offerings. Blank check and blind pool offerings do not qualify for CREQUITY. CR-EQUITY may not be available on an offering even if the offering fits within the initial
screening criteria.
Attach this request to the front of the Form U-1, Uniform Application to Register Securities and state
in bold type in the cover letter accompanying the application that the application is pursuant to CREQUITY. CR-EQUITY is available only if the issuer intends to register in two or more of the
participating states.
Set forth below are the states participating in CR-EQUITY. Please indicate the CR-EQUITY states in
which you intend to file an application to register your securities. These states also should be listed in
item 7 of the Form U-1 in addition to all other states in which application for registration is being
made.1 Issuers are cautioned to identify all states in which they intend to utilize the CREQUITY registration process. In accordance with the CR-EQUITY Protocol, it may not be
possible to include additional states at a later date. The review process will not begin until such
time as all states identified on the CR-EQUITY-1 have received an application to register securities.
9Alabama (M)
9Alaska (M)
9Arizona (M)
9Arkansas (M)
9California (M)
9Delaware (D)
9District of Columbia (D)
9Idaho (M)
9Indiana (M)
9Iowa (M)
M =Merit
9Kansas (M)
9Kentucky (D)
9Maine (M)
9Maryland (D)
9Massachusetts (M)
9Michigan (M)
9Minnesota (M)
9Mississippi (M)
9Missouri (M)
9Montana (M)
9Nebraska (M)
9New Hampshire (D)
9New Jersey (D)
9New Mexico (M)
9Nevada (D)
9North Carolina (D)
9North Dakota (M)
9Oklahoma (M)
9Oregon (M)
9Pennsylvania (M)
9Rhode Island (D)
9South Carolina(M)
9South Dakota (D)
9Texas (M)
9Utah (D)
9Vermont (M)
9Virginia (M)
9Washington (M)
9West Virginia (D)
9Wisconsin (D)
D=Disclosure
(Though designated Disclosure Jurisdictions, District of Columbia, New Jersey and West Virginia reserve the
right to make substantive comments in select areas.)
1
Because the states of Colorado, Connecticut, Florida, Georgia, Hawaii, Illinois, Louisiana, New York, and Wyoming provide
automatic effectiveness for files coordinated with the Securities and Exchange Commission, those states are not included in the
project.
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The state of Pennsylvania is acting as CR-EQUITY Administrator. Please file a copy of this form
along with the Registration Statement and Prospectus with the Pennsylvania Securities Commission
even if the issuer does not intend to register its shares for sale in Pennsylvania. There is no additional
fee for coordinated review. Do not send fees to Pennsylvania unless the issuer intends to register its
securities in Pennsylvania.
The Applicant attests that all Registration Statements and Prospectuses will be identical in each of the
states listed in the attached Form U-1 and that all applications will be filed contemporaneously in
those states.
Subsequent amendments to the Registration Statement will also be filed
contemporaneously in the states identified above. The CR-EQUITY process will take a minimum of
30 days. The applicant should consider this time frame and file the CR-EQUITY-1 as soon as
possible after filing with the Securities and Exchange Commission.
The Applicant understands that any application filed in a state subsequent to the initial filing may be
reviewed separately and may involve application of non-CR-EQUITY standards. The Applicant
should understand that the merit states participating in CR-EQUITY will be using certain NASAA
Guidelines as the uniform standard. For information on the standards to be applied, please contact the
Pennsylvania Securities Commission at (717) 787-5401.
The Applicant agrees to resolve comments through the Lead Disclosure and the Lead Merit states until
such time as the Lead states agree that the comment should be resolved through direct contact between
the applicant and the state with the unresolved comment.
Authorized Representative
_____________________________
Print Name
____________________________
Title
_____________________________
Name of Issuer
____________________________
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