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Statement Of Eligibility For Registration By Notification NJBOS-7 - New Jersey
| Statement Of Eligibility For Registration By Notification Form. This is a New Jersey form and can be used in Securities Blue Sky Secretary Of State . |
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NEW JERSEY BUREAU OF SECURITIES th 153 Halsey Street, 6 Floor PO Box 47029 Newark, NJ 07101 (973) 504-3600 STATEMENT OF ELIGIBILITY FOR REGISTRATION BY NOTIFICATION (Pursuant to N.J.S.A. 49:3-61.2) 1. Name of Issuer _____________________________________________________________ 2. Original date of organization of the issuer _________________________ _______________ Number of years issuer has been in continuous operation ___________________ ___________ If issuer has been in continuous operation less than 5 years, give names of predecessors & state length of time each has been in operation: __________________________________________ ________________________________________________________________________ ____ ________________________________________________________________________ ____ 3. Has there been any default during the current fiscal year or within the 3 preceding fiscal years in the payment of principal, interest, or dividends on any security (of the issuer or any predeces- sor) with a fixed maturity or a fixed interest or dividend provision? ______________________ ________________________________________________________________________ ____ 4. State the net earnings of the issuer and any predecessors during the past 3 full fiscal years, determined in accordance with generally accepted accounting principles, which are applicable to all securities without a fixed maturity or a fixed interest or dividend provision, which securities are outstanding at the date the registration statement is filed. Fiscal year ended Net earnings 1. ___________________________________ _______________________________ 2. ___________________________________ _______________________________ 3. ___________________________________ _______________________________ Total _______________________________ Average net earnings (divide total by 3) ______________________ _________ American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 2 2 5. If the securities of the issuer or any of its predecessors (which do not have a fixed maturity or a fixed interest or dividend provision) have been outstanding for 3 full fiscal years, complete the chart below. (Include all securities which will be outstanding if all the securities being offered or proposed to be offered are issued, whether or not they are proposed to be registered or offered in New Jersey.) Market Book Description No. of Maximum price per value per of units offering unit as unit as Securities now price of of Total outstand- per unit ________ ________ value ing (1) date (1) date (2) (3) _____________ _______ $ _______ $ _______ $ _______ $ _______ _____________ _______ $ _______ $ _______ $ _______ $ _______ _____________ _______ $ _______ $ _______ $ _______ $ _______ A. Total Value $ _____________ B. 5% of total value $ _____________ C. Average net earnings $ _____________ (restate from Item 4) In order to qualify for Registration by Notification, C must be greater than or equal to B. (1) The maximum offering price or the market price on a day selected by the applicant, but must be within 30 days before the date of filing this registration statement. (2) Book value must be of a day, selected by the applicant, within 90 days of filing this registra- tion statement. Book value may be used only if there is neither a readily determinable market price nor a cash offering price. (3) The total value is the product of either (1) the number of units multiplied by the higher of the maximum offering price or the market price, or (2) the number of units multiplied by the book value. American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 3 3 6. If the securities of the issuer or any of its predecessors (which do not have a fixed maturity or a fixed interest or dividend provision) have not been outstanding for 3 full fiscal years, complete the chart below. (Include all securities which will be outstanding if all the securities being of- fered or proposed to be offered are issued, whether or not they are proposed to be registered or offered in New Jersey.) Market Book Description No. of Maximum price per value per of units offering unit as unit as Securities now price of of Total outstand- per unit _______ _______ value ing (1) date (1) date (2) (3) _____________ _______ $ _______ $ _______ $ _______ $ _______ _____________ _______ $ _______ $ _______ $ _______ $ _______ _____________ _______ $ _______ $ _______ $ _______ $ _______ A. Total Value $ _____________ B. 5% of total value $ _____________ C. Average net earnings $ _____________ (restate from Item 4) In order to qualify for Registration by Notification, C must be greater than or equal to B. Notes (1), (2), and (3) are explained on the previous page. The registrant certifies that it has reasonable grounds to believe that it meets all of the require- ments for filing pursuant to N.J.S.A. 49:3-61.2. Date: ____________________________ Issuer: ____________________________ By: ______________________________ Title: _____________________________ Form NJBOS-7 9/2003 American LegalNet, Inc. www.USCourtForms.com
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