The Securities and Exchange Commission has not necessarily reviewed the information in this filing and has not determined if it is accurate and complete. | |||||||||||||||||
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM D Notice of Exempt Offering of Securities |
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1. Issuer's Identity
CIK (Filer ID Number) | Previous Names |
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0001287121 |
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Name of Issuer | |||||||||||||||
CROSSHAIR EXPLORATION & MINING CORP | |||||||||||||||
Jurisdiction of Incorporation/Organization | |||||||||||||||
BRITISH COLUMBIA, CANADA | |||||||||||||||
Year of Incorporation/Organization | |||||||||||||||
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2. Principal Place of Business and Contact Information
Name of Issuer | |||
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CROSSHAIR EXPLORATION & MINING CORP | |||
Street Address 1 | Street Address 2 | ||
1140 WEST PENDER STREET | SUITE 1240 | ||
City | State/Province/Country | ZIP/PostalCode | Phone Number of Issuer |
VANCOUVER | BRITISH COLUMBIA, CANADA | V6E 4G1 | 604-681-8030 |
3. Related Persons
Last Name | First Name | Middle Name |
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Morabito | Mark | J. |
Street Address 1 | Street Address 2 | |
5572 Molina Road | ||
City | State/Province/Country | ZIP/PostalCode |
North Vancouver | BRITISH COLUMBIA, CANADA | V7R 4P4 |
Relationship: | X | Executive Officer | X | Director | Promoter |
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Clarification of Response (if Necessary):
Last Name | First Name | Middle Name |
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Wallis | Stewart | |
Street Address 1 | Street Address 2 | |
1419 - 133A Street | ||
City | State/Province/Country | ZIP/PostalCode |
Surrey | BRITISH COLUMBIA, CANADA | V4A 6A2 |
Relationship: | X | Executive Officer | X | Director | Promoter |
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Clarification of Response (if Necessary):
Last Name | First Name | Middle Name |
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Beaven | Horace | |
Street Address 1 | Street Address 2 | |
2437 Lexington St. | ||
City | State/Province/Country | ZIP/PostalCode |
Lafayette | COLORADO | 80026 |
Relationship: | X | Executive Officer | Director | Promoter |
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Clarification of Response (if Necessary):
Last Name | First Name | Middle Name |
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Paine | Sheila | |
Street Address 1 | Street Address 2 | |
#1701 - 7360 Halifax Street | ||
City | State/Province/Country | ZIP/PostalCode |
Burnaby | BRITISH COLUMBIA, CANADA | V5A 1M4 |
Relationship: | X | Executive Officer | Director | Promoter |
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Clarification of Response (if Necessary):
Last Name | First Name | Middle Name |
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Johnston | Evelyn | |
Street Address 1 | Street Address 2 | |
#156 - 2000 Panorama Drive | ||
City | State/Province/Country | ZIP/PostalCode |
Port Moody | BRITISH COLUMBIA, CANADA | V3H 5J5 |
Relationship: | X | Executive Officer | Director | Promoter |
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Clarification of Response (if Necessary):
Last Name | First Name | Middle Name |
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Sujir | Jay | |
Street Address 1 | Street Address 2 | |
6933 Laburnum Street | ||
City | State/Province/Country | ZIP/PostalCode |
Vancouver | BRITISH COLUMBIA, CANADA | V6P 5M8 |
Relationship: | Executive Officer | X | Director | Promoter |
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Clarification of Response (if Necessary):
Last Name | First Name | Middle Name |
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Smith | Ian | |
Street Address 1 | Street Address 2 | |
3608 West 7th Avenue | ||
City | State/Province/Country | ZIP/PostalCode |
Vancouver | BRITISH COLUMBIA, CANADA | V6R 1W4 |
Relationship: | Executive Officer | X | Director | Promoter |
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Clarification of Response (if Necessary):
Last Name | First Name | Middle Name |
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Collingwood | Chris | |
Street Address 1 | Street Address 2 | |
410 East White Hills Road | PO Box 5367 | |
City | State/Province/Country | ZIP/PostalCode |
St. John's | NEWFOUNDLAND, CANADA | A1C 5W2 |
Relationship: | Executive Officer | X | Director | Promoter |
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Clarification of Response (if Necessary):
Last Name | First Name | Middle Name |
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Gill | Derrick (Rick) | |
Street Address 1 | Street Address 2 | |
98 Waterford Bridge Road | ||
City | State/Province/Country | ZIP/PostalCode |
St. John's | NEWFOUNDLAND, CANADA | A1E 1C8 |
Relationship: | Executive Officer | X | Director | Promoter |
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Clarification of Response (if Necessary):
Last Name | First Name | Middle Name |
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Ludwig | Mark | |
Street Address 1 | Street Address 2 | |
229 Bannock Street | ||
City | State/Province/Country | ZIP/PostalCode |
Denver | COLORADO | 80223-1301 |
Relationship: | X | Executive Officer | Director | Promoter |
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Clarification of Response (if Necessary):
Last Name | First Name | Middle Name |
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Bell | Tom | |
Street Address 1 | Street Address 2 | |
65 Howe Road | ||
City | State/Province/Country | ZIP/PostalCode |
Cohasset | MASSACHUSETTS | 02025 |
Relationship: | X | Executive Officer | Director | Promoter |
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Clarification of Response (if Necessary):
Last Name | First Name | Middle Name |
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Yik | Sam | |
Street Address 1 | Street Address 2 | |
875 West 47th Avenue | ||
City | State/Province/Country | ZIP/PostalCode |
Vancouver | BRITISH COLUMBIA, CANADA | V5Z 2R7 |
Relationship: | X | Executive Officer | Director | Promoter |
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Clarification of Response (if Necessary):
4. Industry Group
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5. Issuer Size
Revenue Range | OR | Aggregate Net Asset Value Range | ||
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No Revenues | No Aggregate Net Asset Value | |||
$1 - $1,000,000 | $1 - $5,000,000 | |||
$1,000,001 - $5,000,000 | $5,000,001 - $25,000,000 | |||
$5,000,001 - $25,000,000 | $25,000,001 - $50,000,000 | |||
$25,000,001 - $100,000,000 | $50,000,001 - $100,000,000 | |||
Over $100,000,000 | Over $100,000,000 | |||
X | Decline to Disclose | Decline to Disclose | ||
Not Applicable | Not Applicable |
6. Federal Exemption(s) and Exclusion(s) Claimed (select all that apply)
Rule 504(b)(1) (not (i), (ii) or (iii)) | Rule 505 | |||||||||||||||||||||||||||||||||||
Rule 504 (b)(1)(i) | X | Rule 506 | ||||||||||||||||||||||||||||||||||
Rule 504 (b)(1)(ii) | Securities Act Section 4(5) | |||||||||||||||||||||||||||||||||||
Rule 504 (b)(1)(iii) | Investment Company Act Section 3(c) | |||||||||||||||||||||||||||||||||||
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7. Type of Filing
X | New Notice | Date of First Sale | 2012-02-27 | First Sale Yet to Occur | |||||
Amendment |
8. Duration of Offering
Does the Issuer intend this offering to last more than one year? |
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9. Type(s) of Securities Offered (select all that apply)
X | Equity | Pooled Investment Fund Interests | |
Debt | Tenant-in-Common Securities | ||
X | Option, Warrant or Other Right to Acquire Another Security | Mineral Property Securities | |
Security to be Acquired Upon Exercise of Option, Warrant or Other Right to Acquire Security | Other (describe) | ||
10. Business Combination Transaction
Is this offering being made in connection with a business combination transaction, such as a merger, acquisition or exchange offer? |
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Clarification of Response (if Necessary):
11. Minimum Investment
Minimum investment accepted from any outside investor | $0 | USD |
12. Sales Compensation
Recipient |
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Street Address 1 | Street Address 2 | ||||||
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City | State/Province/Country | ZIP/Postal Code | |||||
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13. Offering and Sales Amounts
Total Offering Amount | $192,621 | USD |
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Total Amount Sold | $192,621 | USD | ||||
Total Remaining to be Sold | $0 | USD |
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Clarification of Response (if Necessary):
Each unit is comprised of one common share and one-half common share warrant. Each whole warrant entitles the holder to acquire 1 common share at an approximate price of $0.7 through February 27, 2014.14. Investors
Select if securities in the offering have been or may be sold to persons who do not qualify as accredited investors, and enter the number of such non-accredited investors who already have invested in the offering. | |||
Regardless of whether securities in the offering have been or may be sold to persons who do not qualify as accredited investors, enter the total number of investors who already have invested in the offering: |
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15. Sales Commissions & Finder's Fees Expenses
Provide separately the amounts of sales commissions and finders fees expenses, if any. If the amount of an expenditure is not known, provide an estimate and check the box next to the amount.
Sales Commissions | $0 | USD |
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Finders' Fees | $5,665 | USD |
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Clarification of Response (if Necessary):
16. Use of Proceeds
Provide the amount of the gross proceeds of the offering that has been or is proposed to be used for payments to any of the persons required to be named as executive officers, directors or promoters in response to Item 3 above. If the amount is unknown, provide an estimate and check the box next to the amount.
$0 | USD |
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Clarification of Response (if Necessary):
Signature and Submission
Please verify the information you have entered and review the Terms of Submission below before signing and clicking SUBMIT below to file this notice.
Terms of Submission
In submitting this notice, each issuer named above is: |
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Each Issuer identified above has read this notice, knows the contents to be true, and has duly caused this notice to be signed on its behalf by the undersigned duly authorized person.
For signature, type in the signer's name or other letters or characters adopted or authorized as the signer's signature.
Issuer | Signature | Name of Signer | Title | Date |
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CROSSHAIR EXPLORATION & MINING CORP | /s/ Sheila Paine | Sheila Paine | Corporate Secretary | 2012-03-01 |
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.
* This undertaking does not affect any limits Section 102(a) of the National Securities Markets Improvement Act of 1996 ("NSMIA") [Pub. L. No. 104-290, 110 Stat. 3416 (Oct. 11, 1996)] imposes on the ability of States to require information. As a result, if the securities that are the subject of this Form D are "covered securities" for purposes of NSMIA, whether in all instances or due to the nature of the offering that is the subject of this Form D, States cannot routinely require offering materials under this undertaking or otherwise and can require offering materials only to the extent NSMIA permits them to do so under NSMIA's preservation of their anti-fraud authority.