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Issuers Annual Report SD-75 - Indiana
| Issuers Annual Report Form. This is a Indiana form and can be used in Securities Blue Sky Secretary Of State . |
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SD-75 ISSUERS NAME Revised 3/91 ISSUERS REG. NO. INDIANA SECURITIES DIVISION OFFICE OF SECRETARY OF STATE INDIANAPOLIS, INDIANA ISSUERS ANNUAL REPORT Required by 710 IAC 1-11-1 This report is due ninety (90) days after close of issuers fiscal year. Not required if Affidavit of Termination on Form SD-76 has been previously filed. In the Matter of the Condition of (name of issuer) (address) (city) (state) for fiscal year ending . General Character of Issuers Business The undersigned issuer makes the following representations to th e Indiana Securities Commission for the purpose of complying with the provisions of the Indiana Securities Law: SECURITIES REGISTERED IN INDIANA That the following is a complete and correct statement of issu ers securities now registered in Indiana, and the amount sold under such registrat ion: (State number of units and aggregate sale price). Registered Units Amount Sold Units Amount Common stock $ Common stock $ Preferred stock Preferred stock $ $ Bonds $ Bonds $ Trust units $ Trust units $ Other securities Other securities$ $ $ $ 1. That the following broker-dealers are authorized to sell issuer s securities in Indiana: 2. If no broker-dealers are authorized, are securities being offered for sale in Indiana by issuer? 3. That the following agents are registered with issuer in Indiana : (if necessary attach list) 4. Number of options and warrants outstanding: State Form 37149 American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 2SD-75 (continued) That the issuer has made changes in its articles of incorporat ion, by-laws, amount of its capital stock or par value thereof, as follows: (If n ecessary, attach exhibits): That the issuer has, in the six months period ending passed,failed to pass or reduced dividends, as follows: That the issuer has in the said period, failed to meet intere st, maturity, or sinkingfund requirements on its securities as follows: Is the issuer, as a business enterprise, dormant or inactive? If so, give reason: Has registration, license, or application to sell securities in any other state been revoked, cancelled, suspended or withdrawn? If so give reason: Has any change been made since issue was registered, in the n ature or plan of doing business, or in the sale price, or per cent of sales co mmission? If so, explain fully Are issuers idential securities registered under the Federal Se curities Act? In what other states are said securities registered? The following are the present officers and directors of this c orporation: OFFICE NAME ADDRESS President Vice-President: Secretary: Treasurer: Directors (1) (2) (3) (4) (5) ATTACH Issuers Financial Statement for the fiscal year covered by this report. I hereby verify that the statements contained herein and attach ed hereto are true. Issuer By: President or Vice-President Attest: Secretary or Assistant Secretary American LegalNet, Inc. www.USCourtForms.com
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