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Application For Registration Of Securities By Qualification RQ - Alabama
| Application For Registration Of Securities By Qualification Form. This is a Alabama form and can be used in General Blue Sky Secretary Of State . |
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STATE OF ALABAMA OFFICE OF THE SECURITIES COMMISSION MONTGOMERY, ALABAMA APPLICATION FOR REGISTRATION OF SECURITIES BY QUALIFICATION (Application may be made by the issuer, or by a registered dealer) NOTE: The general information required under Items 1 to 10 in clusive of this application form must be supplied, when applicable, by every applicant and conce rning every issue sought to be registered, including applications accompanied by, a Securities and Exchange Commission registration statement. PART 1. General Information: Item 1. Name and address of issuer and principal office in this state: Item 2. Registration is sought in this State for the following describe d securities in the amounts indicated: Description of Securities American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 2 Proposed Maximum Offering Number of Shares Total Amount of Price Per Share or Unit of Units Value of Offering Item 3. Name and address of applicant: Item 4. Name , address and telephone number of correspondent to whom notices and communications regarding this application may be sent: Item 5. Officials of Issuer Give the names, official capacities, and residence address of o fficers, directors, trustees, partners, controlling persons or other officials, of the issuer as of th e date of filing this application. (This information is required to be stated below, by all applicants.) Position Name Residence Address Item 6. Issuer organized under the laws of: American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 3 Date Item 7. Fees: (a) Amount of fees submitted with this application $ . NOTE: Basic filing fee is $40 plus a registration fee of .1% of the agg regate offering in Alabama. Item 8. Federal Registration: (a) Has an application for registration of this offering been filed w ith the Securities and Exchange Commission? Yes No . If yes, answer (b) and (c below. (b) Check one of the following: Full Registration under the Securities Act of 1933 ; Exempt from registration under the Securities Act of 1933 pursuant to Regulation Aor Regulation B Other . (c) What is the contemplated effective or commencement date of the off ering? . Item 9. Has application for registration been made in any other States or jurisdictions? Yes No . If yes, answer (a) and (b) below. (a) List states in which application has been made for registration o f this issue. (b) List all states which have approved any such application. American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 4Item 10. List the maximum amount of commissions and all other expenses , directly or indirectly, for or in connection with the proposed distribution of the issuers secu rities: (a) Underwriting Discounts and Commissions $ (b) Printing and Engraving (c) Legal Fees and Expenses (d) Accounting Fees and Expenses (e) Finders Fees (f) Value of Warrants and Options to Underwriters (g) Securities and Exchange Commission Filing Fee (h) State Filing and Registration Fees and Expenses (i) Miscellaneous: (describe) Total $ PART II Applicant shall furnish the following exhibits, where applicab le, properly numbered: Exhibit 1. Submit 6 copies of the prospectus or offering circular, 6 copies of all amended prospectuses with 1 copy red-lined to indicate changes and 6 copies of t he final prospectus, 1 copy of any Registration Statement, letter or notification or any similar filing made with the Securities and Exchange Commission if appli cable. Submit Commission Exhibit Form 1 for an offering where a Registration St atement or Regulation A Notification has not been filed with the Securities and Exchange Commission. Exhibit 2. Occupational affidavits of officers, directors, partners, tr ustees and controlling persons on Commission Form 1-A. Exhibit 3. Issuers Bond pursuant to Section 34 (c). Exhibit 4. Copy of Articles of Incorporation including amendments the reof, certified by a corporate officer, if issuer is a corporation; or of articles of associa tion, or of partnership or of the instrument under which a trust is created or decla red, if issuer is a trust. American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 5Exhibit 5. By-Laws of Issuer certified by a corporate officer, inclu ding all amendments. Exhibit 6. Copies of Contracts, Indentures, Escrow Agreements, or oth er Instruments affecting any securities to be offered or of a Material Nature to the Issuer. Exhibit 7. Specimen Copy or Copies of the Security or Securities to be offered. Exhibit 8. Financial Statements in compliance with Rule 30-6 certified by independent certified public accountants. Exhibit 9. Name of Registered Alabama Dealer who intends to sell the issue and copies of all Underwriting Agreements and Other Agreements between Dealers and Distrib utors. Exhibit 10. Issuers Consent to Service of Process and Resolution upon C ommission forms provided therefore or Form U-2 and U-2a. Exhibit 11. Opinions of issuers Counsel, as to (a) Validity of this issue of securities. (b) Title to real estate or oil or mining rights or titles in which i ssuer proposes to sell interests. (c) Sufficiency of lease, or leases, when material to the issue. (d) Validity of patent claim or claims, when material to the issue. (e) Basis of, and probable extent of, any liability in the for m of any judgment, claim or lien, existing or that may be created by suit or suits now pend ing against the issuer. Exhibit 12. Copy of any advertising or promotional material to be used in connection with the distribution of the securities. Exhibit 13. Written Consents of Experts. Exhibit 14. Exhibit 15. American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 6The applicant hereby applies for registration of the above-described sec urities under Title 53, Code of Alabama, and in consideration thereof agrees that it will: (a) Advise the Commission of any change in any of the information con tained herein or in any supporting documents submitted with or as a part of this appli cation prior to registration. (b) Advise the Commission of any material adverse change in the finan cial condition or business operations of the issuer during the period of distribution of t he securities sought to be registered herein. (c) File quarterly reports required by Section 34 (g) on Commission Form H. (d) Amend the prospectus or offering circular pursuant to Rule 30-4. (e) Submit every advertisement or sales literature to be used in conn ect
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