Form E (R) (S) (SFN51954) "Issuer Exemption Final Report of Sales" - North Dakota

What Is Form E (R) (S) (SFN51954)?

This is a legal form that was released by the North Dakota Securities Department - a government authority operating within North Dakota. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2021;
  • The latest edition provided by the North Dakota Securities Department;
  • 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 E (R) (S) (SFN51954) by clicking the link below or browse more documents and templates provided by the North Dakota Securities Department.

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Download Form E (R) (S) (SFN51954) "Issuer Exemption Final Report of Sales" - North Dakota

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FORM E (R) (S)
ISSUER EXEMPTION FINAL REPORT OF SALES
Securities Department
NORTH DAKOTA SECURITIES DEPARTMENT
600 E Boulevard Ave Dept 414
SFN 51954 (6-2021)
Bismarck ND 58505
(701) 328-2910
www.securities.nd.gov
REPORT OF SALES OF SECURITIES PURSUANT TO THE NORTH DAKOTA ISSUER EXEMPTION
UNDER SECTION 10-04-06 (9) (B) OF THE NORTH DAKOTA CENTURY CODE
INSTRUCTIONS:
A report of sales must be filed within 30 days after the completion of the offering
or expiration of the twelve-month approval period, whichever occurs first.
CAVEAT:
Intentional misstatements or omissions of material facts constitute criminal violations. (See
Sections 10-40-15(1) and 10-04-18 of the North Dakota Century Code.)
1. Name of Issuer
Address of Issuer (Street)
City
State
ZIP Code
2. Title or Class of Securities Sold
3. Dollar Amount of Securities Sold in North Dakota
4. Number of Buyers to Whom Securities were Sold in North Dakota
5. State each purpose and the amount for each purpose for which the proceeds of this offering have
been or will be used.
6.
State the names of any dealers, salesmen, finders, or other persons who acted on behalf of the
issuer in making offers or sales:
This report is filed by the issuer, through its duly authorized agent, whose signature appears below.
Issuer
Date of Report
Signature of Authorized Agent or Officer:
FORM E (R) (S)
ISSUER EXEMPTION FINAL REPORT OF SALES
Securities Department
NORTH DAKOTA SECURITIES DEPARTMENT
600 E Boulevard Ave Dept 414
SFN 51954 (6-2021)
Bismarck ND 58505
(701) 328-2910
www.securities.nd.gov
REPORT OF SALES OF SECURITIES PURSUANT TO THE NORTH DAKOTA ISSUER EXEMPTION
UNDER SECTION 10-04-06 (9) (B) OF THE NORTH DAKOTA CENTURY CODE
INSTRUCTIONS:
A report of sales must be filed within 30 days after the completion of the offering
or expiration of the twelve-month approval period, whichever occurs first.
CAVEAT:
Intentional misstatements or omissions of material facts constitute criminal violations. (See
Sections 10-40-15(1) and 10-04-18 of the North Dakota Century Code.)
1. Name of Issuer
Address of Issuer (Street)
City
State
ZIP Code
2. Title or Class of Securities Sold
3. Dollar Amount of Securities Sold in North Dakota
4. Number of Buyers to Whom Securities were Sold in North Dakota
5. State each purpose and the amount for each purpose for which the proceeds of this offering have
been or will be used.
6.
State the names of any dealers, salesmen, finders, or other persons who acted on behalf of the
issuer in making offers or sales:
This report is filed by the issuer, through its duly authorized agent, whose signature appears below.
Issuer
Date of Report
Signature of Authorized Agent or Officer: