COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.INTRASTATE 1NY # FILING OF INTRASTATE PROSPECTUS TO: ATTORNEY GENERAL OF THE STATE OF NEW YORK REAL ESTATE FINANCING BUREAU 120 BROADWAY (23RD FLOOR), NEW YORK, N.Y. 10271JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)Re: (Name and address of issuer)(Telephone )The undersigned, being all of the officers, directors and principals of the above issuer, hereby submit to the Attorney General for filing the attached prospectus for its proposed Intrastate Offering of securities. Each of us represents that he or she has carefully read and examined the attached prospectus and the supporting documentation; that the prospectus contains a fair summary of material facts, and does not knowingly omit any material fact or contain any untrue statement of a material fact; that he or she recognizes that these materials are to be used to induce persons to purchase securities in reliance upon the representations contained therein, and authorizes the use of his or her name in the prospectus; and that he or she undertakes to file or cause to be filed all additional reports, documentation and amendments to the prospectus to update it as required by the Office of the Attorney General pursuant to the New York Intrastate Financing Act and the regulations issued thereunder. For the purpose of updating or amending the prospectus or filing required reports, each of us designates the following person or persons to file such documents on behalf of and as attorney in fact for each of us: (list names and addresses). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .THE PEOPLE OF THE STATE OF NEW YORK TOGREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomYour 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. 1. State amount of offering $ Type of securities 2. Check type of prospectus: [ ] full prospectus[ ] short form prospectus (Intrastate 5) [ ] "specialized" prospectus, one of the Justices of the[ ] other (specify) Court in Witness, Honorableday of, 20 County,3. Check category of offering: [ ] regular offering[ ] small offering[ ] specialized offering [ ] offering to a related group(Attorney must sign above and type name below)[ ] other (specify) 4. Has Issuer Statement (Form M-11) been filed? [ ] Yes [ ] No 5. Has a State Notice been filed? [ ] Yes [ ] No 6. Has a Further State Notice been filed? [ ] Yes [ ] NoAttorney(s) forOffice and P.O. AddressSignatureDateName & Title (please print)Telephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comCOURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No. JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)Where additional space is required use an additional Intrastate 1 Form Computation of fee: Minimum Fee $ 25.00 Amount of offering $ x.005 = $ Maximum Fee $1,500.00. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .THE PEOPLE OF THE STATE OF NEW YORK TOGREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomYour 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., one of the Justices of theCourt in Witness, Honorableday of, 20 County,(Attorney must sign above and type name below)Attorney(s) forOffice and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.com
|
Get this form for FREE as a print-only pdf
