|
Your Name – enter your name or nickname as you want it displayed |
|
|
Name of Business |
|
|
Primary area of practice |
please specify field of law here:
|
|
2nd area of practice: (optional) |
please specify field of law here:
|
|
3rd area of practice: |
please specify field of law here:
|
|
4th area of practice: |
please specify field of law here:
|
|
5th area of practice: |
please specify field of law here:
|
|
Location – where you practice law (fill in as many fields as you
would like) |
|
|
|
Note: your profile does not go live until
you contribute a form
|
|
Click image below to see how we display your
profile
|
- Receive a free profile listing your firm's areas of expertise
- All contributed forms prominently display your business profile,
which include the optional fields of your phone number, email, and website address(see
example in top right)
- Connect with thousands of businesses, professionals, and potential
customers looking to use your expertise and services
- Your form will be highly optimized for the search engines, enabling people doing
keyword searches related to your business to find you via the profile we display
about you
- Feel good by giving back to the community by providing quality legal and business
forms for free
- You're protected: all users who download your forms agree to idemnify you Learn More
|
|
|
Your Name – enter your name or nickname as you want it displayed |
|
|
Name of Business |
|
|
2nd area of practice: (optional) |
please specify field of law here:
|
|
3rd area of practice: |
please specify field of law here:
|
|
4th area of practice: |
please specify field of law here:
|
|
5th area of practice: |
please specify field of law here:
|
|
Location – where you practice law (fill in as many fields as you
would like) |
|
|
|
Note: your profile does not go live until
you contribute a form
|
|
Click image below to see how we display your
profile
|
- Receive a free profile listing your firm's areas of expertise
- All contributed forms prominently display your business profile,
which include the optional fields of your phone number, email, and website address(see
example in top right)
- Connect with thousands of businesses, professionals, and potential
customers looking to use your expertise and services
- Your form will be highly optimized for the search engines, enabling people doing
keyword searches related to your business to find you via the profile we display
about you
- Feel good by giving back to the community by providing quality legal and business
forms for free
- You're protected: all users who download your forms agree to idemnify you Learn More
|
|
|
Your Name – enter your name or nickname as you want it displayed |
|
|
Name of Business |
|
|
2nd area of practice: (optional) |
please specify field of law here:
|
|
3rd area of practice: |
please specify field of law here:
|
|
4th area of practice: |
please specify field of law here:
|
|
5th area of practice: |
please specify field of law here:
|
|
Location – where you practice law (fill in as many fields as you
would like) |
|
|
|
Note: your profile does not go live until
you contribute a form
|
|
Click image below to see how we display your
profile
|
- Receive a free profile listing your firm's areas of expertise
- All contributed forms prominently display your business profile,
which include the optional fields of your phone number, email, and website address(see
example in top right)
- Connect with thousands of businesses, professionals, and potential
customers looking to use your expertise and services
- Your form will be highly optimized for the search engines, enabling people doing
keyword searches related to your business to find you via the profile we display
about you
- Feel good by giving back to the community by providing quality legal and business
forms for free
- You're protected: all users who download your forms agree to idemnify you Learn More
|
|
|
Our Spam Policy
We hate getting spam as much as you do. So we have implemented a tough spam policy
regading how we deal with your email. We pledge that we will:
- Never rent, trade, or sell any email or any personal information to any third
party without your explicit consent
Terms Of Use
Submissions to this site, including any legal or business forms, posts, responses
to questions or other communications by contributors are not intended as and should
not be construed as legal advice. You are strongly encouraged to consult competent
legal council before engaging in any action based upon content contained on this
site.
These downloadable forms are only for personal use. Retransmission, redistribution,
or any other commercial use is prohibited. This includes reposting forms from this
site to another site offering free legal or other document forms for download.
Please note that the donator may have included different usage terms regarding this
form, and you agree to abide by these terms. It is highly recommended that you have
a licensed attorney review any legal documents for which you are searching in order
to make sure that your needs are being properly and completely satisfied.
Your use of this site constitutes your acceptance of our terms of use and your agreement
to hold this site, its officers, employees and any contributors to this site harmless
for any damage you might incur from your use of any submissions contained on this
site. If you do not agree to the above terms, please do not proceed.
These forms are provided to assist business owners and others in understanding important
points to consider in different transactions. They are offered with the understanding
that no legal advice, accounting, or other professional service is being offered
by these documents or on this website. Laws vary in the different states. Agreements
acceptable in one state may not be enforced the same way under the laws of another
state. Also, agreements should relate specifically to the particular facts of each
situation. Therefore, it is important to consult legal counsel whenever utilizing
these forms. The Forms are not a substitute for legal advice YourFreeLegalForms.com
is not engaged in recommending or referring members on the site or making claims
about the competence, character or qualifications of its participating members.
Close
Thank you for using
Yourfreelegalforms.com
Your online source for 100% free legal and business forms.
Have a form to contribute?
Contribute a legal or business form, checklist or article and have your profile
displayed on the same page as the form for free, powerfull, targeted marketing to
those searching for legal forms and advice.
Rate this form
(must be logged in)
|
|
Social Bookmark this Form
|
|
|
Advertise your business to thousands for free –
Contribute a form
|
|
Form #1561PURCHASER REPRESENTATIVE QUESTIONNAIRE
|
Average user rating: |
Not Yet Rated
|
Rate it |
|
PURCHASER REPRESENTATIVE QUESTIONNAIRE
this form has not been reviewed by a lawyer
|
PURCHASER
REPRESENTATIVE QUESTIONNAIRE
______________________ Name of
Company
______________________ Address of
Company
______________________
Dear Sir or Madam:
The information contained herein is
being furnished to you in order to enable you to determine whether the
undersigned may act as purchaser representative pursuant to Section 4(2) of the
Securities Act of 1933, as amended, and Regulation D promulgated thereunder in
connection with the proposed offer and sale of
securities of
_____________________________________________ (the ''Company'').
[Please attach additional sheets
if required.]
1. Name
_______________________________________________
Age: _________________
1
Home Address:
_________________________________________
Home Telephone Number:
________________________________
2. My present occupation or position
is as follows:
Firm Name:
________________________________________________
Nature of Business:
.__________________________________________
Position:
___________________________________________________
Nature of Duties:
____________________________________________
Business Address:
___________________________________________
Business Telephone Number:
.__________________________________
1
3. Any other prior occupations or
positions I have held during the past five years:
__________________________________________________________________
__________________________________________________________________
4. I have had prior experience in
advising clients with respect to the following types of investments:
a) Real Estate
_ Yes ____ No ____
b) Oil and Gas
_ Yes ____ No ____
c) Cattle
_ Yes ____ No ____
d) Other Tax Shelters.
_ Yes ____ No ____
5. The professional licenses or
registrations (including bar admissions, accounting certificates, real estate
brokerage licenses, broker dealer or investment advisory registration) held by
me are:
Check if License
License or or
Registration
Registration
Year Received is Still Effective
____________________
____________ ______________
6. (a) Neither I, nor any of my
affiliates*, now have or have had at any time since [two
years previously], any material**
relationship the Company or any of its affiliates and no such relationship is
mutually understood to be contemplated,
except:______________________________________________________________
____________________________________________________________________
* The term ''affiliate'' of a person
means a person that directly or indirectly, through one or more intermediaries,
controls or is controlled by or is under common control with such person.
** The term "material,'' when
used to modify "relationship,'' means any relationship that a reasonable
investor might consider important in the making of the decision to acknowledge
a person as his purchaser representative.
(b) The amounts of compensation
received or to be received as a result of the material relationship(s)
described in Item 6(a) (including any compensation received or to be
received in connection with this
transaction) are:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
______________________________ ______________
Signature of Purchaser Representative Date
Our Spam Policy
We hate getting spam as much as you do. So we have implemented a tough spam policy
regading how we deal with your email. We pledge that we will:
- Never rent, trade, or sell any email or any personal information to any third
party without your explicit consent
Terms Of Use
Submissions to this site, including any legal or business forms, posts, responses
to questions or other communications by contributors are not intended as and should
not be construed as legal advice. You are strongly encouraged to consult competent
legal council before engaging in any action based upon content contained on this
site.
These downloadable forms are only for personal use. Retransmission, redistribution,
or any other commercial use is prohibited. This includes reposting forms from this
site to another site offering free legal or other document forms for download.
Please note that the donator may have included different usage terms regarding this
form, and you agree to abide by these terms. It is highly recommended that you have
a licensed attorney review any legal documents for which you are searching in order
to make sure that your needs are being properly and completely satisfied.
Your use of this site constitutes your acceptance of our terms of use and your agreement
to hold this site, its officers, employees and any contributors to this site harmless
for any damage you might incur from your use of any submissions contained on this
site. If you do not agree to the above terms, please do not proceed.
These forms are provided to assist business owners and others in understanding important
points to consider in different transactions. They are offered with the understanding
that no legal advice, accounting, or other professional service is being offered
by these documents or on this website. Laws vary in the different states. Agreements
acceptable in one state may not be enforced the same way under the laws of another
state. Also, agreements should relate specifically to the particular facts of each
situation. Therefore, it is important to consult legal counsel whenever utilizing
these forms. The Forms are not a substitute for legal advice YourFreeLegalForms.com
is not engaged in recommending or referring members on the site or making claims
about the competence, character or qualifications of its participating members.
Close
Thank you for using
Yourfreelegalforms.com
Your online source for 100% free legal and business forms.
Have a form to contribute?
Contribute a legal or business form, checklist or article and have your profile
displayed on the same page as the form for free, powerfull, targeted marketing to
those searching for legal forms and advice.
Rate this form
(must be logged in)
|
|
Social Bookmark this Form
|
|
Keywords: PURCHASER REPRESENTATIVE QUESTIONNAIRE
|
|
|