Last updated: 11/8/2010
Schedule Supporting Application For Registration Or For Amendment {PTC-2}
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Description
OFFICIAL FORMS PTC-2 BEFORE THE NEVADA GAMING COMMISSION AND THE STATE GAMING CONTROL BOARD In the Matter of Exact Name of Applicant/ Registrant as Specified in Charter (Registration) SCHEDULE SUPPORTING APPLICATION FOR REGISTRATION OR FOR AMENDMENT TO ORDER OF REGISTRATION 1. The Applicant. State the corporate name, address of chief place of business, state of incorporation and telephone number of Applicant. 2. The Corporate Licensee(s). State the corporate name(s) and address(es) of the proposed subsidiary corporate licensee(s) ("Corporate Licensee"). 3. The Transaction. State the method and terms of the proposed transaction by which the Applicant will become subject to registration as a publicly traded corporation, or the circumstances which necessitate an amendment to the Applicant's Order of Registration previously entered. Include a statement of source of funds, if applicable. Also include descriptions required by NRS 463.635(1)(b)(4), (6), (7), (8) and (9). 4. Management and Operating Changes. State any material or major changes in the corporate structure, capitalization, management, and operations of the subsidiary Corporate Licensee to be effected upon registration or the proposed amendment to the relevant Order of Registration. 5. Controlling Persons. State the names, business addresses, home addresses, principal businesses, material relationships to the Applicant, and holdings of American LegalNet, Inc. www.FormsWorkflow.com OFFICIAL FORMS PTC-2 securities issued by the Applicant of all controlling persons (as defined in NGC Regulation 16.010(1)) and of all persons listed in NGC Regulation 16.410. 6. Federal Regulation. State all securities issued by the Applicant (including class, number of shares and principal amount of debt securities) which are registered pursuant to Section 12 of the Securities Exchange Act. If any securities are listed on a national securities exchange, identify the securities and the exchange. If any securities are subject to a pending or presently contemplated application for listing, so state. 7. Nevada Qualification. State when the Applicant was, or will be, qualified to transact business within the State of Nevada; the location of its statutory office in Nevada, and the names of its resident agent in Nevada. 8. Description of Business. Give a brief description of the Applicant's business, properties, management, and organization. 9. Prior Offerings. Give a brief description of all public offerings made by the Applicant, or by any predecessor in interest of the Applicant as to its business and properties, or by any person (other than an individual) which controls the Applicant within the preceding three years. 10. Involvement with Gaming. Fully describe any involvement in gaming outside the State of Nevada by the Applicant or by any person controlling, controlled by, or under common control with, the Applicant. The Applicant states that this Schedule, as amended and supplemented and as of the time it is accepted as filed, does not make a material misstatement of fact nor omit to state a material fact necessary to make the facts stated, in view of the circumstances under which such facts are set forth, not misleading. American LegalNet, Inc. www.FormsWorkflow.com OFFICIAL FORMS PTC-2 The Applicant states that this Schedule, as amended and supplemented and as of the time it is accepted as filed, is in full compliance with the Act and Regulations. The Applicant hereby undertakes to amend and supplement this Schedule as the Board or Commission may require from time to time. The Applicant hereby amends this Schedule on such date or dates as may be necessary to delay the effective date of the Application until such Application, as supplemented and amended, is accepted as filed or the Applicant specifically requests that the Application be accepted as filed, whichever occurs first. Pursuant to the Act and Regulations, the Applicant has duly caused this Schedule to be executed on its behalf by the undersigned, thereunto duly authorized. Applicant By manual signature typed signature title American LegalNet, Inc. www.FormsWorkflow.com OFFICIAL FORMS PTC-2 EXHIBITS: Attach one copy each of the following: documents evidencing the transaction described in paragraph 3; applicant's periodic reports pursuant to section 13 of the Securities Exchange Act filed during the preceding 3 years; all registration statements, proxy statements, and information statements filed under the Federal Securities Act and Federal Securities Exchange Act during the preceding 3 years. Form PTC-2 shall be used to support an application for initial registration of a publicly traded corporation or to support the application for an amendment to any Order of Registration previously entered by the Nevada Gaming Commission, as may be necessary and proper to reflect changes in the activities of, or regulatory approval concerning, the registrant or its subsidiaries and affiliates. In the latter case, the Applicant shall complete as much of Form PTC-2 as may be appropriate under the circumstances. USE: PTC-2 (Rev. 03/06) American LegalNet, Inc. www.FormsWorkflow.com