Form Es - Notice Of Proposed Release Of Funds From Escrow printable pdf download

Form Es - Notice Of Proposed Release Of Funds From Escrow

Colorado Division of Securities

1560 Broadway Street, Suite 900

Denver, CO 80202

File No. _________________________

NOTICE OF PROPOSED RELEASE OF FUNDS FROM ESCROW

Pursuant to the requirements of section 11-51-302(6), C.R.S., this notice of proposed release of

funds from escrow and the following information is submitted:

1. Name of Offering:

2. Name of Issuer:

Address of Issuer:

4. Was the offering registered under Statute section 11-51-303, C.R.S., in Colorado?

______YES ______NO

If so, list the date the registration statement became effective. _____/_____/_____.

5. Was the offering registered under Statute section 11-51-304, C.R.S., in Colorado?

_____YES_____NO. If so, list the registration statement number assigned by the Colorado

Division of Securities:

6. List the gross amount of proceeds received from the sale of any and all of the securities

registered in Colorado:

7. Has the offering closed? ________YES________NO. Will any additional funds be received

by the issuer in exchange for securities issued in this offering? ________YES________NO.

If yes, state the amount of additional funds:

8. Has a transaction or series of transactions committing at least fifty percent (50%) of the gross

proceeds for use in one or more specific lines of business been completed? _____YES

_____NO. Describe the transaction or series of transactions, including the date of each

transaction, the parties to each transaction, the amount committed, a description of how the

proceeds are to be spent under the terms of each transaction, and the specific lines of business.

(use a separate page if necessary):

FORM ES (Rev. 7-2006)

Form Es - Notice Of Proposed Release Of Funds From Escrow