SEC - 816 Form 2-A - Report of Sales And Uses of Proceeds

UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

FORM 2-A

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3235-0286
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November 30, 2007
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REPORT OF SALES AND USES OF PROCEEDS
PURSUANT TO RULE 257 OF REGULATION A
File No. 24- _____–___
For period ending ____/____/____
Indicate whether the report is an

initial report
[ ]
amendment
[ ]
or final report [ ]

If the report is an amendment, indicate the number of such amendment.
If the offering has terminated, indicate the date of termination ____/____/____

GENERAL INSTRUCTIONS
The report shall be filed in accordance with the provisions of Rule 257 of Regulation A.
Answer each item in the box(es) or spaces provided. If additional space is required for any response, continue the response on
an attached sheet.
If the issuer is required to file any report(s) on this form subsequent to its initial filing, each subsequent filing shall be deemed
an amendment to the initial filing. Do not report in any amendment responses to Items 3-11 unless the information has changed.
No fee is required to accompany this filing.
Seven copies of the form shall be filed with the main office of the Commission in Washington, D.C. At least one copy of the form
shall be manually signed; other copies may bear typed or printed signatures.
1.____________________________________________________________________________________________________________________________
Exact name of issuer as specified in its charter.
2. Date of qualification of the offering statement:

3. Has the offering commenced?

[ ] Yes [ ] No.

If yes, date of commencement:
If no, explain briefly:
______________________________________________________________________________________________
4. Did the offering terminate before any securities were sold?
[ ] Yes [ ] No.
If yes, explain briefly:
___________________________________________________________________________________________
If “yes”, do not answer Items 5-11.
5.

Did the offering terminate prior to the sale of all the securities qualified under Regulation A?
[ ] Yes [ ] No.
If yes, explain briefly: __________________________________________________________________________________________

SEC 816 (04-05)

Persons who are to respond to the collection of information
contained in this form are not required to respond unless the
form displays a currently valid OMB control number.

6. Indicate the total number of shares or other units offered and sold to date:
(issuer’s account)
Indicate the number of shares or other units still being offered:
(issuer’s account)
7.

8.

Total amount of dollars received from the public to date.
Total amount allocable to selling securityholders:
Underwriting discount or commission allowed
Underwriting expenses paid
Finders’ Fees
Other expenses paid to date by or for issuer:
Legal (including organization)
Accounting
Engineering
Printing and Advertising
Other (specify)
____________________________
____________________________
Total costs and expenses
Total net proceeds remaining.

(selling securityholders)

(selling securityholders)
$
$
$
$
$
$
$
$
$
$
$
$
$

Uses of net proceeds to date.
Instructions:
1.

Do not include any amount in “working capital” to which a more specific category is applicable.

2.

Round all amounts to the nearest dollar.

3.

Specify under “other purposes” any purpose for which at least 5% of the issuer’s proceeds or $50,000, whichever is less, has been
used.

Salaries and fees
Construction of plant, building and facilities
Purchases and installation of machinery and equipment
Purchase of real estate
Acquisition of other business(es)
Repayment of indebtedness
Working capital
Development expense (product development, research, patent costs, etc.)
Temporary investment (specify)
____________________________
____________________________
Other purposes (specify)
____________________________
____________________________
9.

$
$
$
$
$
$
$
$
$
$
$
$
$

Do the use(s) of proceeds in Item 8 represent a material change in the use(s) of proceeds described in the offering circular?
[ ] Yes [ ] No.
If yes, explain briefly: __________________________________________________________________________

10. State the number of shares held by each promoter, director, officer or controlling person of the issuer, if different from the amount
stated in the offering circular.
11. List the names and addresses of all brokers and dealers who have, to the knowledge of the issuer or underwriters, participated in the
distribution of the securities during the period covered by this report.
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SIGNATURE
Pursuant to the requirements of Rule 257 and Regulation A, ______________________________________________________
has caused this report to be signed on its behalf by the undersigned thereunto duly authorized.
__________________________________________________________________
Issuer
___________________
Date

By _________________________________________________________________
Signature

Instruction:
The report shall be signed by an executive officer, general partner or counsel of the issuer or by any other duly
authorized person. The name and any title of the person who signs the report shall be typed or printed beneath the
signature.

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