Form Y "Limited Offering Exemption. Notice of Claim of Exmption. Under Section 58-13c-202y, Nmsa 1978" - New Mexico

What Is Form Y?

This is a legal form that was released by the New Mexico Regulation & Licensing Department - a government authority operating within New Mexico. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2010;
  • The latest edition provided by the New Mexico Regulation & Licensing Department;
  • Easy to use and ready to print;
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  • Fill out the form in our online filing application.

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Download Form Y "Limited Offering Exemption. Notice of Claim of Exmption. Under Section 58-13c-202y, Nmsa 1978" - New Mexico

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(Rev. 01/10)
FORM Y LIMITED OFFERING EXEMPTION
NOTICE OF CLAIM OF EXEMPTION
UNDER SECTION 58-13C-202Y, NMSA 1978
TO:
DIRECTOR, SECURITIES DIVISION
STATE OF NEW MEXICO
Notice is hereby given that the undersigned Company (corporation, limited partnership, limited
liability company or limited liability partnership), claiming the exemption afforded by Section 58-
13C-202Y, NMSA 1978, intends to avail itself of said exemption with respect to offers and sales
of its securities as hereinafter set forth. In support therefore, it submits the following information
and exhibits:
A.
GENERAL INFORMATION
1.
Name and mailing address of Company.
2.
Type of entity (corporation, limited partnership, limited liability company, limited liability
partnership or other).
3.
Date and place of creation (incorporation, organization, filing or date of partnership
agreement).
4.
Term of entity (if applicable).
5.
Purpose or investment objective of business.
6.
Address where books and records, stock certificates or capital accounts are kept and by
whom.
7.
Estimated number of persons to whom offers will be made.
8.
Number of current security holders.
9.
Name and address of each person who will be effecting or attempting to effect sales of
securities.
B.
GOVERNING INSTRUMENTS
Attach a copy of the Articles of Incorporation, Articles of Organization, Registration of Limited
Liability Partnership, Certificate of Limited Partnership or other instruments of creation of the
Company, including all amendments.
(Rev. 01/10)
FORM Y LIMITED OFFERING EXEMPTION
NOTICE OF CLAIM OF EXEMPTION
UNDER SECTION 58-13C-202Y, NMSA 1978
TO:
DIRECTOR, SECURITIES DIVISION
STATE OF NEW MEXICO
Notice is hereby given that the undersigned Company (corporation, limited partnership, limited
liability company or limited liability partnership), claiming the exemption afforded by Section 58-
13C-202Y, NMSA 1978, intends to avail itself of said exemption with respect to offers and sales
of its securities as hereinafter set forth. In support therefore, it submits the following information
and exhibits:
A.
GENERAL INFORMATION
1.
Name and mailing address of Company.
2.
Type of entity (corporation, limited partnership, limited liability company, limited liability
partnership or other).
3.
Date and place of creation (incorporation, organization, filing or date of partnership
agreement).
4.
Term of entity (if applicable).
5.
Purpose or investment objective of business.
6.
Address where books and records, stock certificates or capital accounts are kept and by
whom.
7.
Estimated number of persons to whom offers will be made.
8.
Number of current security holders.
9.
Name and address of each person who will be effecting or attempting to effect sales of
securities.
B.
GOVERNING INSTRUMENTS
Attach a copy of the Articles of Incorporation, Articles of Organization, Registration of Limited
Liability Partnership, Certificate of Limited Partnership or other instruments of creation of the
Company, including all amendments.
C.
REPRESENTATIONS
The undersigned represents:
1.
That the number of security holders will not in consequence of any sale made under the
exemption afforded by Section 58-13C-202Y exceed twenty five.
2.
That sales have been and will be made only to buyers believed to be purchasing for
investment.
3.
That no commissions or other remunerations have been, are being, or will be paid or
given, directly or indirectly, for soliciting prospective buyers except to broker dealers
and sales representatives licensed pursuant to the New Mexico Uniform Securities Act.
4.
That neither news releases, advertisements in newspapers, radio, television nor any
other form of public advertising will be used in any manner to contact prospective
buyers.
5.
That it understands that acceptance of this notice filing does not constitute approval or
recommendation by the Director of the Securities Division of the securities to be issued
and sold.
6.
That the promoters and persons listed under paragraph II, above, understand the
provisions of Section 58-13C-501, New Mexico Uniform Securities Act, which states
that in connection with the offer to sell, sale, offer to purchase or purchase of a security,
a person shall not, directly or indirectly employ any device, or artifice to defraud; make
an untrue statement of a material fact where such an omission would be misleading; or
engage in an act, practice or course of business which operates or would operate as a
fraud or deceit upon a person.
___________________
____________________________________
Date
Name of Company
____________________________________
Printed Name
_________________________________
Signature and Title of Authorized Person
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