Application For Registration Of Securities {133.7} | Pdf Fpdf Doc Docx | Texas

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Application For Registration Of Securities {133.7} | Pdf Fpdf Doc Docx | Texas

Application For Registration Of Securities {133.7}

This is a Texas form that can be used for State Securities Board within Secretary Of State, Blue Sky.

Alternate TextLast updated: 6/20/2006

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Form 133.7 Texas State Securities Board P.O. Box 13167 Austin, Texas 78711-3167 Application for Registration of Securities, Section 7, Article 581, Vernons Annotated Civil Statutes The Texas Securities Act ANSWER ALL QUESTIONS. IF NOT APPLICABLE, SO STATE. 1. Name of applicant. If the applicant is not the issuer, state the capacity in which the application is made (e.g., licensed dealer): If the applicant is a corporation, certify that franchise taxes owed to the State of Texas are current. If the applicant is a corporation exempt from the payment of franchise taxes, or an out-of-state corporation that is not subject to Texas franchise taxes, certify to that effect. 2. Correspondent: Firm: Address: Telephone: ( ) 3. Name of Issuer: (a) Address of Issuers principal office: (b) Address of Issuers principal office in Texas: 4. Is the filing under the Texas Securities Act, Section 7.A ( ), 7.B ( ), or 7.C ( )? NOTE: An applicant filing under the Texas Securities Act, Section 7.A, is cautioned to observe the audited financial statement requirements of Sections 7.A(1)f and 7.D, unless the issuer is a small business issuer as defined in Rule 113.5. (See Rule 113.5 for financial statement requirements.) 5. Date of Issuers fiscal year end: A-13 02-24-2004 American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 2Form 133.7 6. Describe the securities to be offered in Texas: Quantity of Type of Maximum Price Aggregate Maximum Securities Securities Per Unit Offering Price Describe the securities to be offered in the total offering: Quantity of Type of Maximum Price Aggregate Maximum Securities Securities Per Unit Offering Price 7. Maximum commissions: ______%. Estimate other offering expenses: 8. Amount of fees submitted with this application: $ NOTE: Fees are 1/10 of 1% of the aggregate amount of securities to be sold to Texas residents plus the applicable filing fee. Current information on fees is available on the Agencys web site (www.ssb.state.tx.us) or by contacting the State Securities Board. 9. If registration application has been made with the Securities and Exchange Commission, state the effective date thereof or the expected date of effectiveness: 10. Submit one copy of each of the following documents and indicate the documents submitted. Include: (a) Securities and Exchange Commission Registration Statement; (b) preliminary prospectus and all amendments thereto; (c) each of the following, which may be in preliminary form, with a definitive copy furnished when available: Issuers charter and all amendments; Issuers bylaws and all amendments; Underwriting agreement; Agreement among underwriters and dealers; Opinion of counsel; Specimen copy of security; and Firm offering price commitment from managing underwriter; A-14 02-24-2004 American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 3Form 133.7 (d) all advertising to be used in connection with the offering of the securities in Texas; and (e) if the Issuer is organized under the laws of any other state, territory, or government, or domiciled in any other state than Texas, a consent to service of process under proper resolution or authority of the governing body of the Issuer. 11. (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 sales of the securities to the public, or have revoked or suspended the right to sell the securities, or in which an application has been withdrawn: 12. Describe any stop order, denial, order to show cause, suspension or revocation order, injunction or restraining order, withdrawal order or permission, or similar order issued to date by any state regulatory body, or other governmental 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 attach copies of any materials pertaining to any such orders: 13. The applicant agrees: (a) that any changes or amendments in the prospectus or registration statement shall be furnished with changes, additions, or deletions marked; (b) that within two days after the filing under the Securities Act of 1933 of the final prospectus or of any further amendments or supplements thereto, whether post- effective or otherwise, one copy thereof will be filed with the State Securities Board; A-15 02-24-2004 American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 4Form 133.7 (c) that upon receipt of notice by the issuer or applicant of any orders of the Securities and Exchange Commission issued under Section 8(b) (Refusal Order Proceeding) or Section 8(d) (Stop Order Proceeding) of the Securities Act of 1933, in connection with the registration of the securities thereunder, and of any notice of effectiveness of said registration, notice thereof will be given to the State Securities Board by any means of electronic submission, such as graphic scanning, modem or facsimile, provided, however, that the office of the State Securities Board has the necessary equipment to accept such a transmission; (d) that upon receipt of notice by the issuer or applicant of any stop order, denial, order to show cause, suspension or revocation order, injunction or restraining order, withdrawal order or permission, or similar order issued by any state regulatory body, or other governmental authority, or by any court, concerning the securities covered by this application, or other securities of the issuer currently being offered to the public, notice thereof will be given to the State Securities Board by any means of electronic submission, such as graphic scanning, modem or facsimile; provided, however, that the office of the State Securities Board has the necessary equipment to accept such a transmission; and (e) that it will promptly furnish all such additional information and documents regarding the issuer or the securities covered by this application as may be requested by the Securities Commissioner prior to registration. Signed and sealed this day of , 20 (Name of Applicant) By: (Title) Attest: (Secretary or Partner) STATE OF COUNTY OF The undersigned, being duly sworn, deposes and says that he or she executed the foregoing application for and on behalf of the applicant named therein; that he or she is (title) of such applicant an

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