Form LOE "Notice of Limited Offering Exemption" - Delaware

What Is Form LOE?

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

Form Details:

  • The latest edition provided by the Delaware Department of Justice;
  • 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 printable version of Form LOE by clicking the link below or browse more documents and templates provided by the Delaware Department of Justice.

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Download Form LOE "Notice of Limited Offering Exemption" - Delaware

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FORM LOE
Delaware Department of Justice
Division of Securities
Notice of
th
Limited Offering Exemption
820 N. French Street, 5
Floor
Wilmington, DE 19801
1. Issuer’s Contact Information
Issuer’s Name:
Contact Person’s Name:
Contact Person’s Address:
Contact Person’s Telephone Number:
Contact Person’s E-Mail Address:
Address for Principal Place of Business (if different from above):
2. Type of Business
(Briefly described the type of business in which the issuer is engaged.)
3. Offering Amounts
Total amount to be offered (everywhere):
Total amount to be offered in Delaware:
Total amount raised so far (everywhere):
Total amount raised so far in Delaware:
FORM LOE
Delaware Department of Justice
Division of Securities
Notice of
th
Limited Offering Exemption
820 N. French Street, 5
Floor
Wilmington, DE 19801
1. Issuer’s Contact Information
Issuer’s Name:
Contact Person’s Name:
Contact Person’s Address:
Contact Person’s Telephone Number:
Contact Person’s E-Mail Address:
Address for Principal Place of Business (if different from above):
2. Type of Business
(Briefly described the type of business in which the issuer is engaged.)
3. Offering Amounts
Total amount to be offered (everywhere):
Total amount to be offered in Delaware:
Total amount raised so far (everywhere):
Total amount raised so far in Delaware:
4. Control Person(s) Contact Information
Enter contact information for all officers, directors, general or managing partners, and persons
who own of record (or beneficially) 10 percent or more of the outstanding shares of any class of
equity security of the issuer.
Name:
Title:
Address:
Telephone Number:
E-Mail Address:
Name:
Title:
Address:
Telephone Number:
E-Mail Address:
Name:
Title:
Address:
Telephone Number:
E-Mail Address:
Name:
Title:
Address:
Telephone Number:
E-Mail Address:
(Continue on a separate sheet if necessary)
5. Control Person(s) Background
Has any control person listed above ever been:
Yes G G G G
No G G G G
(a) convicted of a felony?
(b) convicted of a misdemeanor involving any aspect of
Yes G G G G
No G G G G
the securities business?
Yes G G G G
No G G G G
(c) adjudicated bankrupt?
Yes G G G G
No G G G G
(d) a principal of any company which was reorganized in bankruptcy?
Yes G G G G
No G G G G
(e) the assignor of a general assignment for the benefit of creditors?
(f) the subject of (or a principal of a company that has been the subject
of) any administrative, civil or criminal proceeding instituted by a state
Yes G G G G
No G G G G
or federal securities regulatory agency?
If the response to any of the above questions is yes,
explain in detail:
(Continue on a separate sheet if necessary)
6. Investor(s) Information
(Enter contact information for each person residing in Delaware who has purchased the security
that is being offered.)
Name:
Address:
Telephone Number:
E-Mail Address:
Amount Invested:
Name:
Address:
Telephone Number:
E-Mail Address:
Amount Invested:
Name:
Address:
Telephone Number:
E-Mail Address:
Amount Invested:
Name:
Address:
Telephone Number:
E-Mail Address:
Amount Invested:
(continue on a separate sheet if necessary)
7. Purchaser Representative(s) Information
(Enter contact information for any third-person representing a purchaser who resides in
Delaware.)
Name of Representative:
Representative’s Address:
Representative’s Telephone Number:
Representative’s E-Mail Address:
Name of Purchaser Represented:
Purchaser’s Address:
Purchaser’s Telephone Number:
Purchaser’s E-Mail Address:
Name of Representative:
Representative’s Address:
Representative’s Telephone Number:
Representative’s E-Mail Address:
Name of Purchaser Represented:
Purchaser’s Address:
Purchaser’s Telephone Number:
Purchaser’s E-Mail Address:
Name of Representative:
Representative’s Address:
Representative’s Telephone Number:
Representative’s E-Mail Address:
Name of Purchaser Represented:
Purchaser’s Address:
Purchaser’s Telephone Number:
Purchaser’s E-Mail Address:
(Continue on a separate sheet if necessary)
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