Last updated: 8/10/2006
Certification Form {10-2-1B}
Start Your Free Trial $ 13.99What you get:
- Instant access to fillable Microsoft Word or PDF forms.
- Minimize the risk of using outdated forms and eliminate rejected fillings.
- Largest forms database in the USA with more than 80,000 federal, state and agency forms.
- Download, edit, auto-fill multiple forms at once in MS Word using our Forms Workflow Ribbon
- Trusted by 1,000s of Attorneys and Legal Professionals
Description
(Rev.11/16/98) STATE OF UTAH DEPARTMENT OF COMMERCE DIVISION OF SECURITIES FORM 10-2-1B Certification STATE OF ) ) ss. COUNTY OF ) The undersigned, an officer, director, promoter, holder of 10% of the outstanding stock, underwriter or sales agent, or attorney for (the "Company"), being first duly sworn, does hereby certify under oat h that the information in the Companys registration statement submitted to the Utah Department of Commerce, Di vision of Securities is true, accurate and complete to the best of his or her know ledge and that he or she has been diligent in confirming there are no promoters, material transactions, p ayments to related parties, stock distribution arrangements or material compensation arrangements which a re not disclosed in the registration statement. Dated Signature Affiliation with Company Subscribed and sworn to before me this day of , 19 . Notary Public American LegalNet, Inc. www.USCourtForms.com