The Securities and Exchange Commission has not necessarily reviewed the information in this filing and has not determined if it is accurate and complete. The reader should not assume that the information is accurate and complete. |
| UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM D
Notice of Exempt Offering of Securities
| OMB APPROVAL | OMB Number: | 3235-0076 | Estimated average burden | hours per response: | 4.00 |
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1. Issuer's Identity
CIK (Filer ID Number) | Previous Names | | Entity Type |
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0001505987 | | | Corporation | | Limited Partnership | | Limited Liability Company | | General Partnership | | Business Trust | X | Other (Specify) |
Aztec XI Program (the Program) is the offering subject of this filing. If accepted, investors become partners of a partnership with Aztec Energy LLC Managing General Partner. Only one partnership is offered at a time until closed. |
Name of Issuer |
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Aztec XI-B Oil & Gas LP/Aztec Energy LLC |
Jurisdiction of Incorporation/Organization |
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NEVADA |
Year of Incorporation/Organization |
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| Over Five Years Ago | X | Within Last Five Years (Specify Year) | 2010 | | Yet to Be Formed |
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2. Principal Place of Business and Contact Information
Name of Issuer |
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Aztec XI-B Oil & Gas LP/Aztec Energy LLC |
Street Address 1 | Street Address 2 |
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ONE RIVERWAY | SUITE 1580 |
City | State/Province/Country | ZIP/PostalCode | Phone Number of Issuer |
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HOUSTON | TEXAS | 77056 | (713) 840-6444 |
3. Related Persons
Last Name | First Name | Middle Name |
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Lehrer | Kenneth |
Street Address 1 | Street Address 2 |
---|
One Riverway | Suite 1580 |
City | State/Province/Country | ZIP/PostalCode |
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Houston | TEXAS | 77056 |
Relationship: | | Executive Officer | X | Director | | Promoter |
---|
Clarification of Response (if Necessary):
Director of Aztec Oil & Gas, Inc.
Last Name | First Name | Middle Name |
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Vance | Mark |
Street Address 1 | Street Address 2 |
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One Riverway | Suite 1580 |
City | State/Province/Country | ZIP/PostalCode |
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Houston | TEXAS | 77056 |
Relationship: | | Executive Officer | X | Director | | Promoter |
---|
Clarification of Response (if Necessary):
Director of Aztec Oil & Gas, Inc.
Last Name | First Name | Middle Name |
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Hornbrook | Larry |
Street Address 1 | Street Address 2 |
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One Riverway | Suite 1580 |
City | State/Province/Country | ZIP/PostalCode |
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Houston | TEXAS | 77056 |
Relationship: | X | Executive Officer | | Director | | Promoter |
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Clarification of Response (if Necessary):
CFO of Aztec Oil & Gas, Inc.
Last Name | First Name | Middle Name |
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Wheeler | Dayton |
Street Address 1 | Street Address 2 |
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One Riverway | Suite 1580 |
City | State/Province/Country | ZIP/PostalCode |
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Houston | TEXAS | 77056 |
Relationship: | | Executive Officer | X | Director | | Promoter |
---|
Clarification of Response (if Necessary):
Director of Aztec Oil & Gas, Inc.
Last Name | First Name | Middle Name |
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Cox | Ariane |
Street Address 1 | Street Address 2 |
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One Riverway | Suite 1580 |
City | State/Province/Country | ZIP/PostalCode |
---|
Houston | TEXAS | 77056 |
Relationship: | X | Executive Officer | | Director | | Promoter |
---|
Clarification of Response (if Necessary):
Vice President, Secretary-Treasurer, and Administrative Coordinator of Aztec Oil & Gas, Inc.
Last Name | First Name | Middle Name |
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Johnson | Waylan |
Street Address 1 | Street Address 2 |
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One Riverway | Suite 1580 |
City | State/Province/Country | ZIP/PostalCode |
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Houston | TEXAS | 77056 |
Relationship: | X | Executive Officer | | Director | | Promoter |
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Clarification of Response (if Necessary):
President, Aztec Oil & Gas, Inc.
4. Industry Group
| Agriculture | | Banking & Financial Services | | | Commercial Banking | | Insurance | | Investing | | Investment Banking | | Pooled Investment Fund | | | | Is the issuer registered as an investment company under the Investment Company Act of 1940? | | | | Other Banking & Financial Services |
| | Business Services | | Energy | | | | | | | | | | | | |
| | Health Care | | | | | | | | | | | | Manufacturing | | Real Estate | | | | | | | | | | |
| | Retailing | | Restaurants | | Technology | | | | | | | | Travel | | | | | | | Tourism & Travel Services |
| | | | Other |
|
5. Issuer Size
Revenue Range | OR | Aggregate Net Asset Value Range |
---|
| 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 |
X | $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 |
| 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) |
| | Section 3(c)(1) | | Section 3(c)(9) |
| | Section 3(c)(2) | | Section 3(c)(10) |
| | Section 3(c)(3) | | Section 3(c)(11) |
| | Section 3(c)(4) | | Section 3(c)(12) |
| | Section 3(c)(5) | | Section 3(c)(13) |
| | Section 3(c)(6) | | Section 3(c)(14) |
| |
|
7. Type of Filing
| New Notice | | Date of First Sale | 2010-11-29 | | | First Sale Yet to Occur |
X | Amendment |
8. Duration of Offering
Does the Issuer intend this offering to last more than one year? | | |
9. Type(s) of Securities Offered (select all that apply)
| Equity | | Pooled Investment Fund Interests |
| Debt | | Tenant-in-Common Securities |
| 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 | X | Other (describe) |
| Limited Partnership Units |
10. Business Combination Transaction
Is this offering being made in connection with a business combination transaction, such as a merger, acquisition or exchange offer? | | |
Clarification of Response (if Necessary):
11. Minimum Investment
Minimum investment accepted from any outside investor | $50,000 | USD |
12. Sales Compensation
Recipient | Recipient CRD Number | | None |
|
Frank Currie | 1207937 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
IMS Securities, Inc. | 35567 |
Street Address 1 | Street Address 2 |
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10205 Westheimer | Suite 500 |
City | State/Province/Country | ZIP/Postal Code |
Houston | TEXAS | 77042 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Jeffrey R. Nesseth | 1983482 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
QA3 Financial Corp. | 14754 |
Street Address 1 | Street Address 2 |
---|
7000 Central Parkway | Suite 1340 |
City | State/Province/Country | ZIP/Postal Code |
Atlanta | GEORGIA | 30328 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
COLORADO | GEORGIA | ILLINOIS | IOWA | TEXAS | WISCONSIN |
|
Recipient | Recipient CRD Number | | None |
|
Steve Barton | 2788138 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
QA3 Financial | 14754 |
Street Address 1 | Street Address 2 |
---|
One Valmont Plaza | 4th Floor |
City | State/Province/Country | ZIP/Postal Code |
Omaha | NEBRASKA | 68154 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
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Don DeWaay | 1297174 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
DeWaay Financial Network, Inc. | 30767 |
Street Address 1 | Street Address 2 |
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13001 University Avenue |
City | State/Province/Country | ZIP/Postal Code |
Clive | IOWA | 50325 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
ARKANSAS | FLORIDA | INDIANA | IOWA | KANSAS | MINNESOTA | NORTH CAROLINA | NORTH DAKOTA | SOUTH DAKOTA |
|
Recipient | Recipient CRD Number | | None |
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Kristopher F. Etter | 4562123 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
IMS Securities, Inc. | 35567 |
Street Address 1 | Street Address 2 |
---|
5740 Prospect Avenue | Suite 2000 |
City | State/Province/Country | ZIP/Postal Code |
Dallas | TEXAS | 75206 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
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|
Recipient | Recipient CRD Number | | None |
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Oliver B. Williamson | 4642029 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Calton & Associates, Inc. | 20999 |
Street Address 1 | Street Address 2 |
---|
611 Hambley Blvd. | Suite 3 |
City | State/Province/Country | ZIP/Postal Code |
Pikeville | KENTUCKY | 41501 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Thomas M. Hille | 3070017 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
WFP Securities | 35098 |
Street Address 1 | Street Address 2 |
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689 W. Foothill Blvd. | Suite D |
City | State/Province/Country | ZIP/Postal Code |
Claremont | CALIFORNIA | 91711 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
James O. Conaway | 1920946 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
QA3 Financial Corp. | 14754 |
Street Address 1 | Street Address 2 |
---|
3000 E. Birch Street | #109 |
City | State/Province/Country | ZIP/Postal Code |
Brea | CALIFORNIA | 92821 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Tom D. English | 2459450 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
WFP Securities | 35098 |
Street Address 1 | Street Address 2 |
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5186 Carroll Canyon Rd. |
City | State/Province/Country | ZIP/Postal Code |
San Diego | CALIFORNIA | 92121 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
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David Gleeson | 2918661 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
QA3 Financial | 14754 |
Street Address 1 | Street Address 2 |
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One Valmont Plaza | 4th Floor |
City | State/Province/Country | ZIP/Postal Code |
Omaha | NEBRASKA | 68154 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
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W. Aubrey Morrow | 836500 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Independent Financial Group | 7717 |
Street Address 1 | Street Address 2 |
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12636 High Bluff Dr. | Suite 100 |
City | State/Province/Country | ZIP/Postal Code |
San Diego | CALIFORNIA | 92130 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
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Tom Rehberger | 1493001 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Nelson Reid | 45503 |
Street Address 1 | Street Address 2 |
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14420 W. Sylvanfield Drive | Suite 120 |
City | State/Province/Country | ZIP/Postal Code |
Houston | TEXAS | 77014 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
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Todd Condiff | 5193760 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Heritage Financial | 133019 |
Street Address 1 | Street Address 2 |
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5 Great Valley Parkway | Suite 334 |
City | State/Province/Country | ZIP/Postal Code |
Malvern | PENNSYLVANIA | 19355 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
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Tim Sherer | 833618 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
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J.P. Turner & Company | 43177 |
Street Address 1 | Street Address 2 |
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3060 Peachtree Rd., NW | 11th Floor |
City | State/Province/Country | ZIP/Postal Code |
Atlanta | GEORGIA | 30305 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
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Terry Wheeler | 2163092 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
QA3 Financial | 14754 |
Street Address 1 | Street Address 2 |
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One Valmont Plaza | 4th Floor |
City | State/Province/Country | ZIP/Postal Code |
Omaha | NEBRASKA | 68154 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Steven Orr | 1583467 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
DeWaay Financial Network | 30767 |
Street Address 1 | Street Address 2 |
---|
13001 University Ave. |
City | State/Province/Country | ZIP/Postal Code |
Clive | IOWA | 50325 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Steven Knowlton | 4527446 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
IMS Securities | 35567 |
Street Address 1 | Street Address 2 |
---|
10205 Westheimer | Suite 500 |
City | State/Province/Country | ZIP/Postal Code |
Houston | TEXAS | 77042 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Stephen Scheller | 1732978 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Money Concepts | 12963 |
Street Address 1 | Street Address 2 |
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11440 North Jog Road |
City | State/Province/Country | ZIP/Postal Code |
Palm Beach Gardens | FLORIDA | 33418 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Stacey Rognon | 1898975 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
IMS Securities | 35567 |
Street Address 1 | Street Address 2 |
---|
10205 Westheimer | Suite 500 |
City | State/Province/Country | ZIP/Postal Code |
Houston | TEXAS | 77042 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Joshua Patterson | 3077302 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
IMS Securities | 35567 |
Street Address 1 | Street Address 2 |
---|
10205 Westheimer | Suite 500 |
City | State/Province/Country | ZIP/Postal Code |
Houston | TEXAS | 77042 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Scott Reisenweaver | 2485345 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
QA3 Financial | 14754 |
Street Address 1 | Street Address 2 |
---|
One Valmont Plaza | 4th Floor |
City | State/Province/Country | ZIP/Postal Code |
Omaha | NEBRASKA | 68154 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Scott Mrozek | 2410838 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Financial West | 16668 |
Street Address 1 | Street Address 2 |
---|
4510 E. Thousand Oaks Blvd. |
City | State/Province/Country | ZIP/Postal Code |
Westlake Village | CALIFORNIA | 91362 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Scot Landborg | 4555602 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
QA3 Financial | 14754 |
Street Address 1 | Street Address 2 |
---|
One Valmont Plaza | 4th Floor |
City | State/Province/Country | ZIP/Postal Code |
Omaha | NEBRASKA | 68154 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Aaron Brodt | 5017914 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Meridian United Capital | 122924 |
Street Address 1 | Street Address 2 |
---|
8800 N. Gainey Center Dr. | #176 |
City | State/Province/Country | ZIP/Postal Code |
Scottsdale | ARIZONA | 85258 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Antonio Taddeo | 5110448 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Alternative Wealth Strategies | 130933 |
Street Address 1 | Street Address 2 |
---|
1040 N. Kings Hwy. | Suite 405 |
City | State/Province/Country | ZIP/Postal Code |
Cherry Hill | NEW JERSEY | 08034 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
James Reardon | 2309779 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Alternative Wealth Strategies | 130933 |
Street Address 1 | Street Address 2 |
---|
1040 N. Kings Hwy. | Suite 405 |
City | State/Province/Country | ZIP/Postal Code |
Cherry Hill | NEW JERSEY | 08034 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Jeff Rachlin | 823547 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Alternative Wealth Strategies | 130933 |
Street Address 1 | Street Address 2 |
---|
1040 N. Kings Hwy. | Suite 405 |
City | State/Province/Country | ZIP/Postal Code |
Cherry Hill | NEW JERSEY | 08034 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Anthony Musto | 2474439 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Calton & Associates | 20999 |
Street Address 1 | Street Address 2 |
---|
14497 N. Dale Mabry Hwy. | Suite 215 |
City | State/Province/Country | ZIP/Postal Code |
Tampa | FLORIDA | 33618 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Eliot Rosenberg | 1056584 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Calton & Associates | 20999 |
Street Address 1 | Street Address 2 |
---|
14497 N. Dale Mabry Hwy. | Suite 215 |
City | State/Province/Country | ZIP/Postal Code |
Tampa | FLORIDA | 33618 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Howard Kaplan | 1171182 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Calton & Associates | 20999 |
Street Address 1 | Street Address 2 |
---|
14497 N. Dale Mabry Hwy. | Suite 215 |
City | State/Province/Country | ZIP/Postal Code |
Tampa | FLORIDA | 33618 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Michael Reedy | 3114264 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Calton & Associates | 20999 |
Street Address 1 | Street Address 2 |
---|
14497 N. Dale Mabry Hwy. | Suite 215 |
City | State/Province/Country | ZIP/Postal Code |
Tampa | FLORIDA | 33618 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Phillip Couture | 734399 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Calton & Associates | 20999 |
Street Address 1 | Street Address 2 |
---|
14497 N. Dale Mabry Hwy. | Suite 215 |
City | State/Province/Country | ZIP/Postal Code |
Tampa | FLORIDA | 33618 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Phillip King | 1839137 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Calton & Associates | 20999 |
Street Address 1 | Street Address 2 |
---|
14497 N. Dale Mabry Hwy. | Suite 215 |
City | State/Province/Country | ZIP/Postal Code |
Tampa | FLORIDA | 33618 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Jason Erickson | 2527905 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Capital Financial Services | 8408 |
Street Address 1 | Street Address 2 |
---|
1 North Main St. |
City | State/Province/Country | ZIP/Postal Code |
Minot | NORTH DAKOTA | 58703 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Robert Scullen | 807388 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Capital Financial Services | 8408 |
Street Address 1 | Street Address 2 |
---|
1 North Main St. |
City | State/Province/Country | ZIP/Postal Code |
Minot | NORTH DAKOTA | 58703 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Al Vanderlaan | 1172406 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Capwest Securities | 30002 |
Street Address 1 | Street Address 2 |
---|
420 10th Street NW |
City | State/Province/Country | ZIP/Postal Code |
Watertown | SOUTH DAKOTA | 57201 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Joshua Cross | 4522751 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
DeWaay Financial | 30767 |
Street Address 1 | Street Address 2 |
---|
13001 University Ave. |
City | State/Province/Country | ZIP/Postal Code |
Clive | IOWA | 50325 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Ronald Melanson | 331467 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
DeWaay Financial | 30767 |
Street Address 1 | Street Address 2 |
---|
13001 University Ave. |
City | State/Province/Country | ZIP/Postal Code |
Clive | IOWA | 50325 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Hunter Brownlie | 2349976 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Financial West | 16668 |
Street Address 1 | Street Address 2 |
---|
4510 E. Thousand Oaks Blvd. |
City | State/Province/Country | ZIP/Postal Code |
Westlake Village | CALIFORNIA | 91362 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Joseph Merback | 2156180 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Financial West | 16668 |
Street Address 1 | Street Address 2 |
---|
4510 E. Thousand Oaks Blvd. |
City | State/Province/Country | ZIP/Postal Code |
Westlake Village | CALIFORNIA | 91362 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Dean Harvey | 3076399 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
IMS Securities | 35567 |
Street Address 1 | Street Address 2 |
---|
10205 Westheimer | Suite 500 |
City | State/Province/Country | ZIP/Postal Code |
Houston | TEXAS | 77042 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
John Bales | 1820734 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
IMS Securities | 35567 |
Street Address 1 | Street Address 2 |
---|
10205 Westheimer | Suite 500 |
City | State/Province/Country | ZIP/Postal Code |
Houston | TEXAS | 77042 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
John Treadway Brogdon | 1450806 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
IMS Securities | 35567 |
Street Address 1 | Street Address 2 |
---|
10205 Westheimer | Suite 500 |
City | State/Province/Country | ZIP/Postal Code |
Houston | TEXAS | 77042 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Leigh Zachary | 2508360 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
IMS Securities | 35567 |
Street Address 1 | Street Address 2 |
---|
10205 Westheimer | Suite 500 |
City | State/Province/Country | ZIP/Postal Code |
Houston | TEXAS | 77042 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Nigel Bowman | 2022439 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
IMS Securities | 35567 |
Street Address 1 | Street Address 2 |
---|
10205 Westheimer | Suite 500 |
City | State/Province/Country | ZIP/Postal Code |
Houston | TEXAS | 77042 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Patrick Cruickshank | 4214868 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
IMS Securities | 35567 |
Street Address 1 | Street Address 2 |
---|
10205 Westheimer | Suite 500 |
City | State/Province/Country | ZIP/Postal Code |
Houston | TEXAS | 77042 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Damian Dering | 2854253 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Independent Financial Group | 7717 |
Street Address 1 | Street Address 2 |
---|
12636 High Bluff Drive | Suite 100 |
City | State/Province/Country | ZIP/Postal Code |
San Diego | CALIFORNIA | 92130 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Peter McNeil | 4378567 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Independent Financial Group | 7717 |
Street Address 1 | Street Address 2 |
---|
12636 High Bluff Drive | Suite 100 |
City | State/Province/Country | ZIP/Postal Code |
San Diego | CALIFORNIA | 92130 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Anthony Mastroianni | 2151249 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
J.P. Turner & Company | 43177 |
Street Address 1 | Street Address 2 |
---|
3060 Peachtree Rd. NW | 11th Floor |
City | State/Province/Country | ZIP/Postal Code |
Atlanta | GEORGIA | 30305 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Anthony Mowrer | 1947261 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
J.P. Turner & Company | 43177 |
Street Address 1 | Street Address 2 |
---|
3060 Peachtree Rd. NW | 11th Floor |
City | State/Province/Country | ZIP/Postal Code |
Atlanta | GEORGIA | 30305 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Clint Gharib | 2070991 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
J.P. Turner & Company | 43177 |
Street Address 1 | Street Address 2 |
---|
3060 Peachtree Rd. NW | 11th Floor |
City | State/Province/Country | ZIP/Postal Code |
Atlanta | GEORGIA | 30305 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
David Johnson | 1010443 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
J.P. Turner & Company | 43177 |
Street Address 1 | Street Address 2 |
---|
3060 Peachtree Rd. NW | 11th Floor |
City | State/Province/Country | ZIP/Postal Code |
Atlanta | GEORGIA | 30305 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
G. Russell Conrad | 2746778 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
J.P. Turner & Company | 43177 |
Street Address 1 | Street Address 2 |
---|
3060 Peachtree Rd. NW | 11th Floor |
City | State/Province/Country | ZIP/Postal Code |
Atlanta | GEORGIA | 30305 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Jason Hawke | 4177415 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | �� | None |
|
J.P. Turner & Company | 43177 |
Street Address 1 | Street Address 2 |
---|
3060 Peachtree Rd. NW | 11th Floor |
City | State/Province/Country | ZIP/Postal Code |
Atlanta | GEORGIA | 30305 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Jeffrey Gove | 5490359 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
J.P. Turner & Company | 43177 |
Street Address 1 | Street Address 2 |
---|
3060 Peachtree Rd. NW | 11th Floor |
City | State/Province/Country | ZIP/Postal Code |
Atlanta | GEORGIA | 30305 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Richard Stocker | 2573644 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
J.P. Turner & Company | 43177 |
Street Address 1 | Street Address 2 |
---|
3060 Peachtree Rd. NW | 11th Floor |
City | State/Province/Country | ZIP/Postal Code |
Atlanta | GEORGIA | 30305 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Royce Running | 5202198 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
J.P. Turner & Company | 43177 |
Street Address 1 | Street Address 2 |
---|
3060 Peachtree Rd. NW | 11th Floor |
City | State/Province/Country | ZIP/Postal Code |
Atlanta | GEORGIA | 30305 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Michael Welch | 4215661 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Kalos Capital | 44337 |
Street Address 1 | Street Address 2 |
---|
12900 Preston Rd | Suite 400 |
City | State/Province/Country | ZIP/Postal Code |
Dallas | TEXAS | 75230 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Robert Tweed | 2339324 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
MAM Securities | 124620 |
Street Address 1 | Street Address 2 |
---|
2060 Huntington Dr. | Suite 1 |
City | State/Province/Country | ZIP/Postal Code |
San Marino | CALIFORNIA | 91108 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Alan Schryer | 1847282 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Money Concepts | 12963 |
Street Address 1 | Street Address 2 |
---|
11440 North Jog Road |
City | State/Province/Country | ZIP/Postal Code |
Palm Beach Gardens | FLORIDA | 33418 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Christopher Passero | 2517681 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Money Concepts | 12963 |
Street Address 1 | Street Address 2 |
---|
11440 North Jog Road |
City | State/Province/Country | ZIP/Postal Code |
Palm Beach Gardens | FLORIDA | 33418 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Craig Sutherland | 2001873 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Money Concepts | 12963 |
Street Address 1 | Street Address 2 |
---|
11440 North Jog Road |
City | State/Province/Country | ZIP/Postal Code |
Palm Beach Gardens | FLORIDA | 33418 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Errol Mathieu | 4483259 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Money Concepts | 12963 |
Street Address 1 | Street Address 2 |
---|
11440 North Jog Road |
City | State/Province/Country | ZIP/Postal Code |
Palm Beach Gardens | FLORIDA | 33418 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
James Danovich | 2782748 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Money Concepts | 12963 |
Street Address 1 | Street Address 2 |
---|
11440 North Jog Road |
City | State/Province/Country | ZIP/Postal Code |
Palm Beach Gardens | FLORIDA | 33418 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Jason Gaylor | 5643268 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Money Concepts | 12963 |
Street Address 1 | Street Address 2 |
---|
11440 North Jog Road |
City | State/Province/Country | ZIP/Postal Code |
Palm Beach Gardens | FLORIDA | 33418 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Keith Offel | 2570946 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Money Concepts | 12963 |
Street Address 1 | Street Address 2 |
---|
11440 North Jog Road |
City | State/Province/Country | ZIP/Postal Code |
Palm Beach Gardens | FLORIDA | 33418 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Kelvin Bishop | 5148999 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Money Concepts | 12963 |
Street Address 1 | Street Address 2 |
---|
11440 North Jog Road |
City | State/Province/Country | ZIP/Postal Code |
Palm Beach Gardens | FLORIDA | 33418 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Edward Scro | 2821985 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Nelson Reid | 45503 |
Street Address 1 | Street Address 2 |
---|
14420 W. Sylvanfield Drive | Suite 120 |
City | State/Province/Country | ZIP/Postal Code |
Houston | TEXAS | 77014 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Matthew Hannan | 4852358 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Nelson Reid | 45503 |
Street Address 1 | Street Address 2 |
---|
14420 W. Sylvanfield Drive | Suite 120 |
City | State/Province/Country | ZIP/Postal Code |
Houston | TEXAS | 77014 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Brent Turner | 2429805 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
QA3 Financial | 14754 |
Street Address 1 | Street Address 2 |
---|
One Valmont Plaza | 4th Floor |
City | State/Province/Country | ZIP/Postal Code |
Omaha | NEBRASKA | 68154 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Frank Norton | 1069797 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
QA3 Financial | 14754 |
Street Address 1 | Street Address 2 |
---|
One Valmont Plaza | 4th Floor |
City | State/Province/Country | ZIP/Postal Code |
Omaha | NEBRASKA | 68154 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Jeffrey Meyers | 2192759 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
QA3 Financial | 14754 |
Street Address 1 | Street Address 2 |
---|
One Valmont Plaza | 4th Floor |
City | State/Province/Country | ZIP/Postal Code |
Omaha | NEBRASKA | 68154 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Joseph Byerly | 4187946 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
QA3 Financial | 14754 |
Street Address 1 | Street Address 2 |
---|
One Valmont Plaza | 4th Floor |
City | State/Province/Country | ZIP/Postal Code |
Omaha | NEBRASKA | 68154 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Justin Irving | 4083643 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
QA3 Financial | 14754 |
Street Address 1 | Street Address 2 |
---|
One Valmont Plaza | 4th Floor |
City | State/Province/Country | ZIP/Postal Code |
Omaha | NEBRASKA | 68154 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Charles Bowers | 27270 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Steven Falk | 14297 |
Street Address 1 | Street Address 2 |
---|
11280 Granite Ridge Dr. | Unit 1042 |
City | State/Province/Country | ZIP/Postal Code |
Las Vegas | NEVADA | 89135 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
Peter Roe | 2255241 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
Veritrust Financial | 106594 |
Street Address 1 | Street Address 2 |
---|
3755 Capital of Texas Hwy S | Ste 130 |
City | State/Province/Country | ZIP/Postal Code |
Austin | TEXAS | 78704 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
John Naviaux | 4895814 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
WFP Securities | 35098 |
Street Address 1 | Street Address 2 |
---|
5186 Carroll Canyon Rd |
City | State/Province/Country | ZIP/Postal Code |
San Diego | CALIFORNIA | 92121 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
Recipient | Recipient CRD Number | | None |
|
John Schooler | 2368308 |
(Associated) Broker or Dealer | | None |
| (Associated) Broker or Dealer CRD Number | | None |
|
WFP Securities | 35098 |
Street Address 1 | Street Address 2 |
---|
5186 Carroll Canyon Rd |
City | State/Province/Country | ZIP/Postal Code |
San Diego | CALIFORNIA | 92121 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States | | All States |
| |
|
13. Offering and Sales Amounts
Total Offering Amount | $50,000,000 | USD | |
Total Amount Sold | $9,919,000 | USD |
Total Remaining to be Sold | $40,081,000 | USD | |
Clarification of Response (if Necessary):
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: | |
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 | $892,710 | USD | |
Finders' Fees | $0 | USD | |
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.
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: |
- Notifying the SEC and/or each State in which this notice is filed of the offering of securities described and undertaking to furnish them, upon written request, in the accordance with applicable law, the information furnished to offerees.*
- Irrevocably appointing each of the Secretary of the SEC and, the Securities Administrator or other legally designated officer of the State in which the issuer maintains its principal place of business and any State in which this notice is filed, as its agents for service of process, and agreeing that these persons may accept service on its behalf, of any notice, process or pleading, and further agreeing that such service may be made by registered or certified mail, in any Federal or state action, administrative proceeding, or arbitration brought against the issuer in any place subject to the jurisdiction of the United States, if the action, proceeding or arbitration (a) arises out of any activity in connection with the offering of securities that is the subject of this notice, and (b) is founded, directly or indirectly, upon the provisions of: (i) the Securities Act of 1933, the Securities Exchange Act of 1934, the Trust Indenture Act of 1939, the Investment Company Act of 1940, or the Investment Advisers Act of 1940, or any rule or regulation under any of these statutes, or (ii) the laws of the State in which the issuer maintains its principal place of business or any State in which this notice is filed.
- Certifying that, if the issuer is claiming a Rule 505 exemption, the issuer is not disqualified from relying on Rule 505 for one of the reasons stated in Rule 505(b)(2)(iii).
|
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 |
---|
Aztec XI-B Oil & Gas LP/Aztec Energy LLC | Ariane Cox | Ariane Cox | Vice President and Administrative Coordinator | 2011-01-06 |
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.