Chamberlin Law Office, P.A.
G. Richard Chamberlin, attorney*
Florida & Georgia Bars only
Ocala Office:
1941 Southeast 51st Terrace
Ocala, Florida 34471
352-694-6714 (voice)
352-694-9178 (fax)
Mail to:
1941 Southeast 51st Terrace
Ocala, Florida 34471
DIRECTOR/OFFICER QUESTIONNAIRE
(Please Print or Type Responses)
TO: Michael H. Jordan
FROM: Vanessa Lindsey
DATE: August 2, 1999
SUBJECT: Due Diligence Disclosures for AmeriNet Group.com, Inc.
Dear Mr. Jordan:
Please provide us with the following information, as soon as possible.
1. Name: Michael H. Jordan
2. (a) Home Address: 21131 NE 24 CT
Miami, Florida 33180
(b) Business Address: same as above
3. (a) Home Phone: 305-933-3183
(b) Business Phone: 305-932-0245
4. Age: 46
5. State positions and offices held or to be held with the juridical entity or
entities disclosed above (each being hereinafter generically referred to as the
"Juridical Entity"), and your term of office for each: * Sunshine
Securities-Series #7 and 24
Zagreus, Inc. formerly Americare Health Group, Inc. as Secretary/Treasurer
and Securities Counseling and Management, Inc. as President
6. State periods during which you have served in such position(s) and
office(s):
January 1996- Present
Since Inception in 1992
7. Is there any arrangement or understanding between you and any other person
pursuant to which you were or will be selected as a director or nominee? yes
____ no X (If "yes," briefly describe such arrangement or understanding, and
name such person. Do not include arrangements with directors and officers acting
solely in their capacities as such.)
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8. State the nature of any family relationship ( by blood, marriage, or
adoption, not more remote than first cousin) between yourself and any
director, executive officer, or person nominated or chosen by the Juridical
Entity to become a director or executive officer.
Not Applicable
9. List all places of employment, their principal business, and your principal
occupation(s) during the last five years, staring with your current positions
and working back in time. Include all positions as an officer, director,
partner, consultant or sole proprietor:
Principal
Dates Location Name of Business Principal Purpose
Occupation
See Number 5
10. State whether any of the businesses listed are parents, subsidiaries, or
affiliates of the Juridical Entity.
Not Applicable
11. State, in detail, the nature of responsibility undertaken by you in the
prior positions listed above. (Answer should include specific principal duties
which relate to the level of your professional competence.)
12. Have you ever held a directorship in any company with a class of securities
registered pursuant to Section 12 of the Securities Exchange Act of 1934 or
subject to the reporting requirements of Section 15(d) of such Act, or of any
company registered as an investment company under the Investment Company Act of
1940? yes ____ no X (if "yes" list all such companies below):
13. During the past five years, has a petition under the federal bankruptcy laws
or under any state insolvency law been filed by or against you, or any
partnership in which you were a general partner within two years before such
filing, or any corporation or business association of which you were an
executive officer within two years before such filing? yes ______ no X. If yes,
please provide specific details and, under separate cover, please provide copies
of any pleadings, orders or judgments associated therewith:
14. During the past five years, has a receiver, fiscal agent, or similar officer
been appointed by a court for your business or property, or any partnership in
which you were a general partner within two years before such appointment, or
any corporation or business association of which you were an executive officer
within two years before such appointment? yes ____ no X. If yes, please provide
specific details and, under separate cover, please provide copies of any
pleadings, orders or judgments associated therewith:
15. During the past five years, have you been convicted in a criminal proceeding
or named the subject of a pending criminal proceeding (excluding minor traffic
violations)? yes ____ no X. If yes, please provide specific details and, under
separate cover, please provide copies of any pleadings, orders or judgments
associated therewith:
16. During the past five years, have you been the subject of any order, judgment
or decree, not subsequently reversed, suspended or vacated, of any court of
competent jurisdiction, permanently or temporarily enjoining you from, or
otherwise limiting your involvement in, the following activities:
(1) Acting as an investment adviser, underwriter, broker or dealer in
securities, or as an affiliated person, director or employee of any investment
company, bank, savings and loan association or insurance company, engaging in or
continuing conduct or practice in connection with such activity? yes ______ no
X. If yes, please provide specific details and, under separate cover, please
provide copies of any pleadings, orders or judgments associated therewith:
(2) Engaging in any type of business practice? yes ______ no X. If yes,
please provide specific details and, under separate cover, please provide copies
of any pleadings, orders or judgments associated therewith:
(3) Engaging in any activity in connection with the purchase or sale of any
security or in connection with any violation of federal or state securities
laws? yes ______ no X. If yes, please provide specific details and, under
separate cover, please provide copies of any pleadings, orders or judgments
associated therewith:
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17. During the past five years, have you been the subject of any order, judgment
or decree, not subsequently reversed, suspended or vacated, on any federal or
state authority barring, suspending or otherwise limiting for more than 60 days
the right of such person to act as an underwriter, investment adviser, broker or
dealer in securities, or as an affiliated person, director or employee of any
investment company, bank, savings and loan association or insurance company, or
engaging in or continuing any conduct or practice in connection with such
activity? yes ______ no X. If yes, please provide specific details and, under
separate cover, please provide copies of any pleadings, orders or judgments
associated therewith:
18. Have you ever been disbarred by any agency of the United States from
contracting with the United States? yes ______ no X. If yes, please provide
specific details and, under separate cover, please provide copies of any
pleadings, orders or judgments associated therewith:
19. Has it ever been the finding of any court of competent jurisdiction, the
Commodity Futures Trading Commission or the Securities and Exchange Commission,
or have you, by agreement or settlement with the foregoing, admitted or
consented to without admitting or denying, to charges that you:
(1) Have violated any provision(s) of the Commodity Exchange Act, the
Securities Act of 1933, the Securities Exchange Act of 1934, the Public Utility
Holding Company Act of 1935, the Trust Indenture Act of 1939, the Investment
Company Act of 1940, the Investment Advisors Act of 1940, the Securities
Investors Act of 1970, the Foreign Corrupt Practices Act of 1977, or any similar
statute of a state or foreign jurisdiction, or any rule or regulation under such
statutes? yes ______ no X. If yes, please provide specific details and, under
separate cover, please provide copies of any pleadings, orders or judgments
associated therewith:
(2) Have aided, abetted, counseled, commanded, induced, or procured the
violation by any other person of such statutes or rules or regulations? yes
______ no X. If yes, please provide specific details and, under separate cover,
please provide copies of any pleadings, orders or judgments associated
therewith:
You should be aware that the Juridical Entity is currently preparing
materials to be filed with the Securities and Exchange Commission in accordance
with rules and regulations of the Securities and Exchange Commission. The
information provided by you on this questionnaire may be used, in whole or in
part, as needed to comply with these rules and regulations. Please also include
with this completed questionnaire a current resume detailing your educational
background (including schools or universities attended, dates of graduation and
degrees received); and listing your work experience during the last five years
(including name of firm, dates of employment, principal positions held and
specific duties involved in those positions, and the nature of business and
location of such firms).
The answers and information which I have given above, including all
supplemental information attached hereto on separate sheets, each of which I
have signed, are true and accurate to the best of my knowledge. I have read and
understand the foregoing and I consent to the use of all or part of the
information provided in this questionnaire in the Registration Statement. I
further certify that the attached resume is a complete and accurate account of
my education, and work experience for the last five years, and that there are no
material facts required to be included therein in order to make the information
therein not misleading, which are not so included therein.
Dated: August 2, 1999
/s/ Michael H. Jordan
-------------------------------
Signature
Please return this completed form to us at the address listed on the letterhead
of this questionnaire!
Very truly yours,
/s/ Vanessa H. Lindsey
Vanessa H. Lindsey
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