Form U-7 - Small Company Offering Registration (Scor) Form Page 15
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38CAPITALIZATION
35.
Indicate the capitalization of the Company as of the most recent balance sheet date, and as
adjusted to reflect the sale of the minimum and maximum amount of securities in this offering and
the use of the net proceeds from this offering.
Amount Outstanding
As of:
As Adjusted
/ / (date)
Minimum
Maximum
Debt:
Short-term debt
(average interest rate
%)
$
$
$
Long-term debt
(average interest rate
%)
$
$
$
Total debt
$
$
$
Stockholders equity (deficit):
Preferred stock - par or stated value
(by class of preferred – in
order of preferences)
_________________________
$
$
$
_________________________
$
$
$
_________________________
$
$
$
Common stock - par or
stated value
$
$
$
Additional paid in capital
$
$
$
Retained earnings (deficit)
$
$
$
Total stockholders equity (deficit)
$
$
$
Total Capitalization
$
$
$
Small Company Offering Registration (SCOR) Form
Page - 15
Revised: September 28, 1999
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