Filing Of Intrastate Prospectus {1} | Pdf Fpdf Docx | New York

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Filing Of Intrastate Prospectus {1} | Pdf Fpdf Docx | New York

Filing Of Intrastate Prospectus {1}

This is a New York form that can be used for Intrastate Offerings within Statewide, Real Estate, Financing.

Alternate TextLast updated: 4/26/2019

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INTRASTATE 1 NY # FILING OF INTRASTATE PROSPECTUSTO: ATTORNEY GENERAL OF THE STATE OF NEW YORKREAL ESTATE FINANC BUREAUNEW YORK, NY 1Re: (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 theattached prospectus for its proposed Intrastate Offering of securities. Each of us represents that he or she has carefully read and examinedthe attached prospectus and the supporting documentation; that the prospectus contains a fair summary of material facts, and does notknowingly omit any material fact or contain any untrue statement of a material fact; that he or she recognizes that these materials are tobe used to induce persons to purchase securities in reliance upon the representations contained therein, and authorizes the use of his orher name in the prospectus; and that he or she undertakes to file or cause to be filed all additional reports, documentation andamendments to the prospectus to update it as required by the Office of the Attorney General pursuant to the New York IntrastateFinancing 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 tofile such documents on behalf of and as attorney in fact for each of us: (list names and addresses) 1.State amount of offering $ Type of securities 2.Check type of prospectus:[ ] full prospectus[ ] short form prospectus (Intrastate 5)[ ] "specialized" prospectus [ ] other (specify) 3.Check category of offering:[ ] regular offering [ ] small offering[ ] specialized offering[ ] offering to a related group[ ] other (specify) 4.Has Issuer Statement (Form M-11) been filed? [ ] Yes [ ] No5.Has a State Notice been filed? [ ] Yes [ ] No 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com 6.Has a Further State Notice been filed? [ ] Yes [ ] NoSignatureName & Title (please print)DateWhere additional space is required use an additional Intrastate 1 FormComputation of fee: Minimum Fee $ 25.00Amount of offering $ x.005 = $ Maximum Fee $1,500.002 of 2 American LegalNet, Inc. www.FormsWorkFlow.com

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