Discontinuance Of Offering {ATS-2-4-6}

ATS-2(Rev. /) To:Investor Protection New York State Office of the Attorney General New York, NY DISCONTINUANCE OF OFFERING RE: NAME OF COMPANY ADDRESS OF COMPANY NAME OF PRODUCTION The offering of the above company, which was filed in your office on with a capitalization of $, was discontinued on , 19 . (The following must be answered) 1.Was any money raised from investors for this production? Yes [ ] No [ ] If the answer to above is yes, complete the following. 2.State the amount raised (including front money). 3.State the total number of investors (including all front money investors). 4.Was any front money raised? Yes [ ] No [ ] If yes, (a) State the amount of front money raised. (b) State the number of front money investors. (c) Attach copies of all front money agreements. 5.How many investors authorized immediate use of their investment and did not waive refund? . How much was raised? . 6.How many investors authorized immediate use of their investment and waived refund? Page 1of 4Investors - ATS 2 American LegalNet, Inc. www.FormsWorkFlow.com . How much was raised? . 7.What is the name of the special bank account and the names and addresses of all banks in which investors' funds were deposited? 8.If any of the funds were expended, attach a schedule showing the amounts and purposes for which expended. 9.State the date of the initial expenditure of investors' funds. 10.State how much has been returned to investors. On what date? . Attach evidence of refunds, i.e. cancelled check or other evidence. 11.State any other disposition of funds (explain). The foregoing is a true, accurate and complete statement. DateProducer DateProducer DateProducer Sworn to before me this day of 19 . NOTARY PUBLIC ATS - 4 NOTIFICATION OF INTENT TO PROCEED BY MEANS OF WAIVERS Re: NAME OF COMPANY Page 2of 4Investors - ATS 2 American LegalNet, Inc. www.FormsWorkFlow.com ADDRESS OF COMPANY NAME OF PRODUCTION NAME AND ADDRESSES OF ALL PRODUCERS The producer(s) of the above production, do hereby notify the Office of the Attorney General of our intention to proceed with this offering by means of waivers. Initial investor funds for the above production, other than front money, were received on . We make such notification based upon the aforesaid and upon our undertaking to file: All ori g inal waivers, two copies of the investment a g reement and one cop y of the certificate of limited partnership (if this form is used) not later than the first paid performance of the production, together with one copy of all contracts and options with authors or a statement b y us or the attorne y for the production that we have secured the rights to the production or an option therefor from the authors. Further, at the time of filing, we shall represent that we have no knowled g e or belief that the offerin g was made to more than 35 offerees and that we do not know of an y investors represented b y nominees other than those listed on the waivers as submitted. DateProducer DateProducer DateProducer ATS - 6 PRODUCER'S REPRESENTATION RE: NAME OF COMPANY ADDRESS OF COMPANY NAME OF PRODUCTION NAME AND ADDRESSES OF ALL PRODUCERS Page 3of 4Investors - ATS 2 American LegalNet, Inc. www.FormsWorkFlow.com The producer(s) of the above production, do hereb y represent that we have no knowled g e or belie f that the offering in connection with the above production was made to more than thirty - five (35) offerees and that we do not know of an y investors represented b y nominees other than those listed on the waivers as submitted. DateProducer DateProducer DateProducer Page 4of 4Investors - ATS 2 American LegalNet, Inc. www.FormsWorkFlow.com