Model Accredited Investor Exemption Uniform Notice Of Transaction {MAIE}

STATE OF CONNECTICUT DEPARTMENT OF BANKING SECURITIES AND BUSINESS INVESTMENTS DIVISION 260 CONSTITUTION PLAZA HARTFORD, CT 06103-1800 MODEL ACCREDITED INVESTOR EXEMPTION UNIFORM NOTICE OF TRANSACTION NOTICE OF SALE OF SECURITIES PURSUANT TO ACCREDITED INVESTOR EXEMPTION 1. Issuer Name: Address: Phone No.: 2. Form of Organization (Check one): ( ) Corporation ( ) Limited Liability Company ( ) Limited Partnership ( ) Unincorporated Association ( ) Other (Specify) Issuers state of incorporation or jurisdiction of organization: Date of incorporation of organization: 3. Officers and directors (or persons acting in a similar capacit y). Include Names, Addresses and Phone Numbers: American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 2Page 2 4. This Offering: Price Per Security Number of Aggregate Description of Securities Dollar Security to be Amount Offered Debt Equity (common or preferred) Convertible Security Partnership Interests/Other (Specify) 5. Description of Business: 6. Name of Broker-dealer who has solicited or intends to solicit purchasers in this state. Address: By filing this Notice of Transaction, the Issuer of these securities her eby represents that: (1) Sales of securities shall be made only to accredi ted investors as defined in 17 CFR 230.501(a); (2) the Issuer is not an issuer in the development stage that either has no specific business plan or purpose or has indica ted that its business plan is to engage in a merger or acquisition with an unidentifi ed American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 3Page 3 company or companies, or other entity or person; and (3) the Issuer re asonably believes that all purchasers are purchasing for investment and not with the view to or for sale in connection with a distribution of the security. Any r esale of a security sold in reliance on this exemption within 12 months of sale, ex cept a resale to an accredited investor or pursuant to a registration statement effective under applicable state securities law, shall be presumed to be with a vi ew to distribution and not for investment. Securities issued under this exempt ion may only be resold pursuant to registration or an exemption under applicable state securities law. The undersigned represents that the Issuer is familiar with the conditio ns that must be satisfied to be entitled to the Accredited Investor Exemption of the state in which this notice is filed and understands that the Issuer claiming t he availability of this exemption has the burden of establishing that these conditions have been satisfied. The Issuer has read this notification and knows the contents to be true and has duly caused this notice to be signed on its behalf by the undersigned du ly authorized person. Issuer (Print or type): Signature: Name (Print or type): Title (Print or type): Date: American LegalNet, Inc. www.USCourtForms.com