Form Srq-1 - Quarterly Status Report Of Registration And Use Of Proceeds

Form Srq-1 - Quarterly Status Report Of Registration And Use Of Proceeds - 1999

securities@oag.state.md.us

FORM SRQ-1

QUARTERLY STATUS REPORT OF REGISTRATION AND USE OF PROCEEDS

1. Name of issuer:

Address:

Maryland file no.:

Original effective date in Maryland:

2. Description of securities:

3. Period covered by current report:

thru

4. Name of all broker-dealers and individual issuer agents offering in Maryland the securities described in #2:

5. OFFERING STATISTICS

Minimum

Maximum

Price

Offering Amount $

Per Share $

PROCEEDS TO

UNDERWRITING

THE COMPANY

DISCOUNT/COMMISSIONS

Total amount offered in Maryland . . . . . . . . . . . . .

Aggregate subscriptions received or amount sold

to date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Aggregate subscriptions received or amount sold

since last report . . . . . . . . . . . . . . . . . . . . . . . . . . .

Unsold amount of remaining offering . . . . . . . . . .

Amount remaining to break escrow, or . . . . . . . . .

Date escrow was satisfied:

Form Srq-1 - Quarterly Status Report Of Registration And Use Of Proceeds - 1999