Form DBO-SB978 "Real Estate Related Information Required Pursuant to Corporations Code Section 25102.2" - California

What Is Form DBO-SB978?

This is a legal form that was released by the California Department of Financial Protection and Innovation - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on December 1, 2017;
  • The latest edition provided by the California Department of Financial Protection and Innovation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DBO-SB978 by clicking the link below or browse more documents and templates provided by the California Department of Financial Protection and Innovation.

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Download Form DBO-SB978 "Real Estate Related Information Required Pursuant to Corporations Code Section 25102.2" - California

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STATE OF CALIFORNIA – DEPARTMENT OF BUSINESS OVERSIGHT
REAL ESTATE RELATED INFORMATION REQUIRED PURSUANT
TO CORPORATIONS CODE SECTION 25102.2
DBO-SB 978 Form (Rev. 12-17)
DEPARTMENT OF BUSINESS OVERSIGHT
APP NO., if any:
RE-
(Insert App No(s) of Previous Filings
Before the Division, if any)
Check: Transaction Under Section Code
25102(e)
25102(f)
25102(h)
25102(n)
25100(p)
Name of Issuer:
Issuer’s State (or Other Jurisdiction) of Incorporation or Organization:
Address of Principal Place of Business:
Number and Street
City
State
Zip Code
Mailing Address:
Number and Street
City
State
Zip Code
Area Code and Telephone Number:
Title of class(s) of securities to be sold in the transaction:
1. Names and titles of the issuer’s officers and directors of the corporation, managers of a
manager-managed limited liability company, members of a member-managed limited liability
company, general partners in a limited partnership, or other persons performing similar
functions for other types of issuers.
_____________________________________________________________________________________________________
Full Name
Title
If additional space is needed for the names, check this box and attach a separate sheet of
paper to the form and label as Item 1.
2. The offering disclosure documents provided to prospective purchasers. Attach the
documents to the form and label as Item 2.
STATE OF CALIFORNIA – DEPARTMENT OF BUSINESS OVERSIGHT
REAL ESTATE RELATED INFORMATION REQUIRED PURSUANT
TO CORPORATIONS CODE SECTION 25102.2
DBO-SB 978 Form (Rev. 12-17)
DEPARTMENT OF BUSINESS OVERSIGHT
APP NO., if any:
RE-
(Insert App No(s) of Previous Filings
Before the Division, if any)
Check: Transaction Under Section Code
25102(e)
25102(f)
25102(h)
25102(n)
25100(p)
Name of Issuer:
Issuer’s State (or Other Jurisdiction) of Incorporation or Organization:
Address of Principal Place of Business:
Number and Street
City
State
Zip Code
Mailing Address:
Number and Street
City
State
Zip Code
Area Code and Telephone Number:
Title of class(s) of securities to be sold in the transaction:
1. Names and titles of the issuer’s officers and directors of the corporation, managers of a
manager-managed limited liability company, members of a member-managed limited liability
company, general partners in a limited partnership, or other persons performing similar
functions for other types of issuers.
_____________________________________________________________________________________________________
Full Name
Title
If additional space is needed for the names, check this box and attach a separate sheet of
paper to the form and label as Item 1.
2. The offering disclosure documents provided to prospective purchasers. Attach the
documents to the form and label as Item 2.
STATE OF CALIFORNIA – DEPARTMENT OF BUSINESS OVERSIGHT
REAL ESTATE RELATED INFORMATION REQUIRED PURSUANT
TO CORPORATIONS CODE SECTION 25102.2
DBO-SB 978 Form (Rev. 12-17) Page 2 of 2
3. List all state and federal licenses required to offer the securities and engage in real estate
related activities.
License Number
License Expiration Date
Name and Jurisdiction of Licensing Authority (complete for each license):
California Department of Business Oversight’s Division of Corporations California
Financing Law
Corporate Securities Law of 1968
Broker-Dealer
Investment Adviser
California Department of Real Estate, Real Estate Law
Securities and Exchange Commission
FINRA (Financial Industry Regulatory Authority)
Other
If additional space is needed for the licenses, check this box and attach a separate sheet of
paper to the form and label as Item 3.
4. Names, titles and license numbers of all licensed persons who will undertake activities
concerning the securities offering.
Full Name
Title
License Number
If additional space is needed for the names, check this box and attach a separate sheet of
paper to the form and label as Item 4.
1
Date
Print Name and Title of Signatory
Authorized Signature on Behalf of Issuer
Name, Address, Phone Number and E-mail of Contact Person
1 The form must be signed and dated by an authorized officer, director, general partner or trustee of the
issuer (or a person occupying a position with the issuer of equivalent responsibility, or by the authorized
attorney of the issuer).
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