Form D-1 - Notice Of Sale Of Securities Pursuant To The Delaware Limited Offering Exemption Form - State Of Delaware Page 2

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7.
State the dollar amount raised or sought to be raised by the offering:
8.
State the dollar amount raised or sought to be raised by the offering in Delaware, if different than
item 7 above:
9.
Provide the names and home and business addresses of all officers, directors, general or managing
partners. List all persons who own of record, or beneficially own, 10 percent or more of the
outstanding shares of any class of equity security of the Issuer:
NAME AND ADDRESS
POSITION
_______________________________________
(Attach sheet if additional space is required)
10. State whether any of the persons named in Item No. 9 has ever been convicted of a felony, convicted
of any misdemeanor involving any aspect of the securities business, adjudicated bankrupt or made
a general assignment for the benefit of creditors or been a principal of any company which was
reorganized in bankruptcy, or whether any of such persons or companies has been the subject of an
administrative, civil or criminal proceeding instituted by a state or federal securities agency. If the
answer is "yes" explain fully:
____________________________________
_____________________________________________
2

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