Solicitation Of Interest Form For Issuers Organized Or Based In Kansas {KSC-15}

OFFICE OF THE KANSAS SECURITIES COMMISSIONER FORM KSC-15 SOLICITATION OF INTEREST FORM FOR ISSUERS ORGANIZED OR BASED IN KANSAS NOTE TO USERS: This form may only be used by Companies organized or base d in Kansas and must be filed with the Kansas Securities Commissioner at least 10 days prior to any solicitations of interest asprovided under K.A.R. 81-5-12. The form sets forth the minimum informati onal requirements for soliciting indications of interest under federal and state securities la ws. You may include additionalinformation if you think it necessary or desirable. Remember that any di scussion in this document issubject to the anti-fraud provisions of federal and state securities law s and must thereby be complete.Also, any discussion of potential rewards of the proposed investment mus t be balanced by a discussionof possible risks. You may alter the graphic presentation of the form in any way as long as the minimuminformation is clearly presented. Name of Company Street Address of Principal Office: Company Telephone Number: Date and state of Organization: Amount of Proposed Offering: Name of Chief Executive Officer: THIS IS A SOLICITATION OF INTEREST ONLY. NO MONEY OR OTHER CONSIDERATION IS BEING SOLICITED AND NONE WILL BE ACCEPTED. NO SALES OF THE SECURITIES WILL BE MADE OR COMMITMENT TO PURCHASE ACCEPTED UNTIL THE DELIVERY OF A FINAL OFFERING CIRCULAR THAT INCLUDES COMPLETE INFORMATION ABOUT THE ISSUER AND THE OFFERING. AN INDICATION OF INTEREST MADE BY A PROSPECTIVE INVESTOR INVOLVES NO OBLIGATION OR COMMITMENT OF ANY KIND. THIS OFFER IS BEING MADE PURSUANT TO AN EXEMPTION FROM REGISTRATION UNDER FEDERAL AND STATE SECURITIES LAWS. NO SALE MAY BE MADE UNTIL THE OFFERING STATEMENT IS QUALIFIED BY THE SEC (IF REQUIRED) AND IS REGISTERED IN THIS STATE. This Company: ( ) has never conducted business operations. ( ) is in the development stage. ( ) is currently conducting operations. ( ) has shown a profit for the last fiscal year. ( ) other (specify) American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 2FORM KSC-15 Page 2 BUSINESS: 1. Describe in general what business the company does or proposes to do, including what products or goods are or will be produced or services tha t are or will be rendered. 2. Describe in general how these products or services are to be produced or rendered and how and when the company intends to carry out its activitie s. OFFERING PROCEEDS: 3. Describe in general how the company intends to use the proceeds of the proposed offering. KEY PERSONNEL OF THE COMPANY: 4. Provide the following information for all officers and directors or pers ons occupying similar positions: Name, Title, Office Address and Telephone Number; Employment History (Employers, titles and dates of positions held durin g the past five years); and Education (degrees, schools and dates). American LegalNet, Inc. www.USCourtForms.com