Arizona > Secretary Of State > Blue Sky > Securities
Uniform Application To Register Securities U-1 - Arizona
| Uniform Application To Register Securities Form. This is a Arizona form and can be used in Securities Blue Sky Secretary Of State . |
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FORM U-1 UNIFORM APPLICATION TO REGISTER SECURITIES Application to . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . of the State of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . pursuant to Section . . . . . . . . . . . . . . . . . . . . . . .. of th e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. Name and address of issuer and principal office in this state: 2. Name, address and telephone number of correspondent to whom notices a nd communications regarding this application may be sent: 3. Name and address of applicant: 4. Registration or acceptance for filing is sought for the following des cribed securities in the amounts indicated: Total Offering Offering in This State Offering Price or Proposed No. of Shares No. of Shares Amount Amount Description of Securities Offering Price or Units or Units $ $ Totals $ $ Indicate the maximum commission to be charged: . . . . . . . . . . . .% 5. Amount of filing and examination fees which are enclosed: $ . . . . . . . . . . $ . . . . . . . . . . 6. A Registration Statement was filed with the Securities and Exchange C ommission on . . . . . . . . . . (date) and (became) (will become) effective on . . . . . . . . . . . . . . . . . (date) 7. (a) List the states in which it is proposed to offer the securities for sale to the public. (b) List the states, if any, in which the securities are eligible for sale to the public. (c) List the states, if any, which have refused, by order or otherwise , to authorize sale of the securities to the public, or have revoked or suspended the right to sell the securities, o r in which an application has been withdrawn. American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 28. Submitted herewith as a part of this application are the following d ocuments (documents on file may be incor- porated by reference): (a) One copy of the Registration Statement and two copies of Prospectus in t he latest form on file under the Securities Act of 1933. (b) Underwriting Agreement, Agreement among Underwriters, and Selected Deale rs Agreement. (c) Indenture. (d) Issuers charter or articles of incorporation as amended to date. (e) Issuers by-laws as amended to date. (f) Signed copy of opinion of counsel filed with Registration Statement purs uant to the Securities Act of 1933. (g) Specimen (type of security) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (h) Consent to service of process accompanied by appropriate corporate resol ution. (i) If an earning computation or similar requirement is required to be met i n this state, attach a separate sheet as an exhibit showing compliance. (j) One copy of all advertising matter to be used in connection with the off ering. (k) Others (list each): 9. The applicant hereby applies for registration or acceptance for filin g of the above described securities under the law cited above and in consideration thereof agrees so long as the regis tration remains in effect that it will: (a) Advise the above named state authority of any change prior to registrati on in this state in any of the in- formation contained herein or in any of the documents submitted with or as a part of this application. (b) File with the above named state authority within two business days after filing with the Securities and Exchange Commission (i) any amendments other than delaying amendments to the federal registration statement designating the changed, revised or added material or informat ion by underlining the same; and (ii) the final prospectus, or any further amendments or supplement s thereto. (c) Notify the above named state authority within two business days (i) up on the receipt of any stop order, denial, order to show cause suspension or revocation order, injunction o r restraining order, or similar order entered or issued by any state or other regulatory authority or by any court concerning the securities covered by this application or other securities of the issuer currently being offered to the public; and (ii) upon the receipt of any notice of effectiveness of said registrat ion by the Securities and Exchange commission. (d) Notify the above named state authority at least two business days prior to the effectiveness of said regis- tration with the Securities and Exchange Commission of (i) any request by the issuer or applicant to any other state or regulatory authority for permission to withdraw any a pplication to register the securities described herein; and (ii) a list of all states in which applications have been filed where the issuer or applicant has received notice from the state authority that the applicat ion does not comply with state requirements and cannot or does not intend to comply with such requireme nts. (e) Furnish promptly all such additional information and documents in respec t to the issuer or the securities covered by this application as may be requested by the above named state authority prior to registration or acceptance for filing. American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 3Form U- 1 Date:.......................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Applicant By . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and Title) STATE OF. . . . . . . . . COUNTY OF . . . . . . . . . . ss The undersigned, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .being first duly sworn, deposes and says: That he has executed the foregoing application for and on behalf of the applicant named therein; that he is . . . . . . . . . . . . . . . . . . . . . .of such applicant and is fully authorized to execute and file such appli cation; that he is famili- ar with such application; and that to the best of his knowledge, informa tion and belief the statements made in such application are true and the documents admitted therewith are true copie s of the originals thereof. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name Subscribed and sworn to before me this . . . . . . .day of. . . . . . . . .,19 . . . . l . . . . . . . . . . . . . . . . . . . . . . . . . . . NOTARY PUBLIC In and for the County of . . . . . . . . . . . . State of . . . . . . . . . . . . . . . . . . . . . . . . . My Commission Expires:
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