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Welcome to Cypress Financial Corporation
Cypress was founded in 1985 and is a privately owned company, headquartered in San Francisco. Cypress specializes in purchasing secondary market equipment leasing transactions from institutional lessors. Acquisitions are made on behalf of Cypress managed investment programs and for Cypress' own account.
In addition, Cypress advises lessees and lessors with respect to end-of-lease negotiations and its executives serve as expert witnesses in litigation..
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| Re: Cypress Income Funds 1-9 |
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http://www.cypressleasing.com/investor/index.html
Welcome to Cypress Investor Services! By clicking on the topics to the right, you can access frequently asked questions, forms which you can use to authorize direct deposit; change your address, broker of record, or distribution information; or re-register your investment. You can also obtain K-1 instructions and provide us with your feedback. In order to view these documents, you will need Adobe Acrobat Reader. Should you have any questions about these forms or any other matter in connection with your investment, please feel free to contact us, toll-free, at (866) 866-9330.
Due to applicable securities laws and regulations, certain information with respect to Cypress' investment programs is restricted. Current investors can access this information by entering the 4-digit numbers indicated in the letter that accompanied their Confirmation of Investment or in the most recent Quarterly Investor Newsletters. Investors may also call Investor Services at (866) 866-9330 to obtain username and password information.
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| Re: Cypress Income Funds 1-9 |
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UNITED STATES SECURITIES
AND EXCHANGE COMMISSION
Washington, D.C.
FORM D
|
OMB APPROVAL
OMB Number: 3235-0076
Expires: September 30, 2008
Estimated Average burden hours per response: 4.0
|
|
Notice of Exempt Offering of Securities
|
| |
| 1. Issuer's Identity |
| CIK (Filer ID Number) |
Previous Name(s) x None |
Entity Type |
|
0001451787
|
|
o Corporation
o Limited Partnership
x Limited Liability Company
o General Partnership
o Business Trust
o Other
|
| Name of Issuer |
|
Cypress Equipment Fund 16, LLC
|
| Jurisdiction of Incorporation/Organization |
| CALIFORNIA |
| |
| Year of Incorporation/Organization |
| |
o |
Over Five Years Ago |
| |
x |
Within Last Five Years (Specify Year) |
2008 |
| |
o |
Yet to Be Formed |
|
| 2. Principal Place of Business and Contact Information |
| Name of Issuer |
|
| Cypress Equipment Fund 16, LLC |
|
| Street Address 1 |
Street Address 2 |
| 188 The Embarcadero, Suite 420 |
|
| City |
State/Province/Country |
ZIP/Postal Code |
Phone No. of Issuer |
| San Francisco |
CA |
94105 |
415-281-3020 |
| Last Name |
First Name |
Middle Name |
| Harwood |
Stephen |
Rogers |
| Street Address 1 |
Street Address 2 |
| 188 The Embarcadero, Suite 420 |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| San Francisco |
CA |
94105 |
| Relationship: |
x |
Executive Officer |
x |
Director |
x |
Promoter |
| Clarification of Response (if Necessary) |
| |
Officer and Director of LLC Manager |
| Last Name |
First Name |
Middle Name |
| Cypress Equipment Management Corp IV |
NA |
|
| Street Address 1 |
Street Address 2 |
| 188 The Embarcadero, Suite 420 |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| San Francisco |
CA |
94105 |
| Relationship: |
x |
Executive Officer |
o |
Director |
x |
Promoter |
| Clarification of Response (if Necessary) |
| |
LLC Manager |
| Last Name |
First Name |
Middle Name |
| Park |
Kenneth |
|
| Street Address 1 |
Street Address 2 |
| 188 The Embarcadero, Suite 420 |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| San Francisco |
CA |
94105 |
| Relationship: |
x |
Executive Officer |
o |
Director |
o |
Promoter |
| Clarification of Response (if Necessary) |
| |
Officer of LLC Manager |
| Last Name |
First Name |
Middle Name |
| Rael |
Daniel |
|
| Street Address 1 |
Street Address 2 |
| 188 The Embarcadero, Suite 420 |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| San Francisco |
CA |
94105 |
| Relationship: |
x |
Executive Officer |
o |
Director |
o |
Promoter |
| Clarification of Response (if Necessary) |
| |
Officer of LLC Manager |
| o |
Agriculture |
|
Health Care |
o |
Retailing |
| |
Banking & Financial Services |
|
o |
Biotechnology |
o |
Restaurants |
| |
o |
Commercial Banking |
|
o |
Health Insurance |
|
Technology |
| |
o |
Insurance |
|
o |
Hospitals & Physicians |
|
o |
Computers |
| |
o |
Investing |
|
o |
Pharmaceuticals |
|
o |
Telecommunications |
| |
o |
Investment Banking |
|
o |
Other Health Care |
|
o |
Other Technology |
| |
o |
Pooled Investment Fund
|
|
|
|
|
Travel |
| |
x |
Other Banking & Financial Services |
o |
Manufacturing |
|
o |
Airlines & Airports |
| |
Real Estate |
|
o |
Lodging & Conventions |
| |
o |
Commercial |
|
o |
Tourism & Travel Services |
| |
o |
Construction |
|
o |
Other Travel |
| |
o |
REITS & Finance |
o |
Other |
| |
o |
Residential |
|
| |
o |
Other Real Estate |
|
| o |
Business Services |
|
| |
Energy |
|
| |
o |
Coal Mining |
|
| |
o |
Electric Utilities |
|
| |
o |
Energy Conservation |
|
| |
o |
Environmental Services |
|
| |
o |
Oil & Gas |
|
| |
o |
Other Energy |
|
| Revenue Range |
Aggregate Net Asset Value Range |
| o |
No Revenues |
o |
No Aggregate Net Asset Value |
| o |
$1 - $1,000,000 |
o |
$1 - $5,000,000 |
| o |
$1,000,001 - $5,000,000 |
o |
$5,000,001 - $25,000,000 |
| o |
$5,000,001 - $25,000,000 |
o |
$25,000,001 - $50,000,000 |
| o |
$25,000,001 - $100,000,000 |
o |
$50,000,001 - $100,000,000 |
| o |
Over $100,000,000 |
o |
Over $100,000,000 |
| x |
Decline to Disclose |
o |
Decline to Disclose |
| o |
Not Applicable |
o |
Not Applicable |
| 6. Federal Exemption(s) and Exclusion(s) Claimed (select all that apply) |
| o |
Rule 504(b)(1) (not (i), (ii) or (iii)) |
o |
Rule 505 |
| o |
Rule 504 (b)(1)(i) |
x |
Rule 506 |
| o |
Rule 504 (b)(1)(ii) |
o |
Securities Act Section 4(6) |
| o |
Rule 504 (b)(1)(iii) |
o |
Investment Company Act Section 3(c) |
| o |
New Notice |
Date of First Sale |
2009-01-07 |
o |
First Sale Yet to Occur |
| Does the Issuer intend this offering to last more than one year? |
x |
Yes |
o |
No |
| 9. Type(s) of Securities Offered (select all that apply) |
| o |
Pooled Investment Fund Interests |
x |
Equity |
| o |
Tenant-in-Common Securities |
o |
Debt |
| o |
Mineral Property Securities |
o |
Option, Warrant or Other Right to Acquire Another Security |
| o |
Security to be Acquired Upon Exercise of Option, Warrant or Other Right to Acquire Security |
o |
Other (describe) |
| |
|
| 10. Business Combination Transaction |
| Is this offering being made in connection with a business combination transaction, such as a merger, acquisition or exchange offer? |
o |
Yes |
x |
No |
| |
| Clarification of Response (if Necessary) |
|
| |
| Minimum investment accepted from any outside investor |
$ 35000 USD |
| Recipient |
Recipient CRD Number |
o |
None |
| Cypress Capital Corporation |
42681 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Cypress Capital Corporation |
42681 |
| Street Address 1 |
Street Address 2 |
| 188 The Embarcader, Suite 420 |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| San Francisco |
CA |
94105 |
| State(s) of Solicitation |
o |
All States |
| AZ AR CA CO CT DC FL GA HI ID IL IN IA KS KY LA MD MA MI MN MO NE NV NJ NY NC OH OR PA SC TN TX UT VT VA WA WI |
| Recipient |
Recipient CRD Number |
o |
None |
| Michael L. Staines, Jr. |
5303142 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Berthel, Fisher and Company Financial Services, Inc. |
13609 |
| Street Address 1 |
Street Address 2 |
| 300 Harding Blvd. |
Suite 209 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Roseville |
CA |
95678 |
| State(s) of Solicitation |
o |
All States |
| AZ CA NJ NY PA TX |
| Recipient |
Recipient CRD Number |
o |
None |
| Zachary L. Carey |
3110546 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Calton and Associates, Inc. |
20999 |
| Street Address 1 |
Street Address 2 |
| 1223 E. Jackson Ave. |
Suite 301 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Oxford |
MS |
38655 |
| State(s) of Solicitation |
o |
All States |
| AL AR FL GA KY LA MS TN TX VA |
| Recipient |
Recipient CRD Number |
o |
None |
| Oliver B. Williamson |
4642029 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Calton and Associates, Inc. |
20999 |
| Street Address 1 |
Street Address 2 |
| 611 Hambley Blvd. |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Pikeville |
KY |
41501 |
| State(s) of Solicitation |
o |
All States |
| FL IN KY MA NY NC OH SC TN VA |
| Recipient |
Recipient CRD Number |
o |
None |
| Phillip D. King |
1839137 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Calton and Associates, Inc. |
20999 |
| Street Address 1 |
Street Address 2 |
| 611 Hambley Blvd. |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Pikeville |
KY |
41501 |
| State(s) of Solicitation |
o |
All States |
| CA FL GA IN KY MI NC OH SC TN VA |
| Recipient |
Recipient CRD Number |
o |
None |
| Maryellen Trotter |
862519 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Centaurus Financial, Inc. |
30833 |
| Street Address 1 |
Street Address 2 |
| 1515 E. Cedar Avenue |
Suite C5 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Flagstaff |
AZ |
86004 |
| State(s) of Solicitation |
o |
All States |
| AZ CA CO FL GA MS NV NM PA |
| Recipient |
Recipient CRD Number |
o |
None |
| Bryan D. Myers |
2527480 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Chapin, Davis |
28116 |
| Street Address 1 |
Street Address 2 |
| 2 Village Square, Suite 200 |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Baltimore |
MD |
21210 |
| State(s) of Solicitation |
o |
All States |
| MD VA |
| Recipient |
Recipient CRD Number |
o |
None |
| Edward W. Grogan IV |
2344994 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Commonwealth Financial Network |
8032 |
| Street Address 1 |
Street Address 2 |
| 6625 Wagner Way NW |
Suite 320 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Gig Harbor |
WA |
98335 |
| State(s) of Solicitation |
o |
All States |
| AK AZ CA CO CT DC FL HI ID KY MD MI MN MT NE NH NY OR SC TX WA WI |
| Recipient |
Recipient CRD Number |
o |
None |
| Robert E. Leib |
1267444 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Commonwealth Financial Network |
8032 |
| Street Address 1 |
Street Address 2 |
| 101 West Elm Street |
Suite 500 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Conshohocken |
PA |
19428 |
| State(s) of Solicitation |
o |
All States |
| CA DE FL IL MD NJ NY NC PA VA |
| Recipient |
Recipient CRD Number |
o |
None |
| Joseph L. England |
2934344 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Commonwealth Financial Network |
8032 |
| Street Address 1 |
Street Address 2 |
| 101 West Elm Street |
Suite 500 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Conshohocken |
PA |
19428 |
| State(s) of Solicitation |
o |
All States |
| DE IN NJ PA |
| Recipient |
Recipient CRD Number |
o |
None |
| Stephen A. Catania |
2389489 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Crown Capital Securities, L.P. |
6312 |
| Street Address 1 |
Street Address 2 |
| 725 Town and Country Road |
Suite 530 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Orange |
CA |
92868 |
| State(s) of Solicitation |
o |
All States |
| GA IL TN VA |
| Recipient |
Recipient CRD Number |
o |
None |
| Melissa C. Mather |
4697533 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Crown Capital Securities, L.P. |
6312 |
| Street Address 1 |
Street Address 2 |
| 1756 Grain Mill Road |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| San Marcos |
CA |
92078 |
| State(s) of Solicitation |
o |
All States |
| CA |
| Recipient |
Recipient CRD Number |
o |
None |
| David B. McMillen |
1198070 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Crown Capital Securities, L.P. |
6312 |
| Street Address 1 |
Street Address 2 |
| 106 Pineview Lane |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Boulder |
CO |
80302 |
| State(s) of Solicitation |
o |
All States |
| CA CO ID OR |
| Recipient |
Recipient CRD Number |
o |
None |
| David A. Harris |
500413 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| David Harris and Co., Inc. |
45670 |
| Street Address 1 |
Street Address 2 |
| 222 Mamaroneck Avenue |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| White Plains |
NY |
10605 |
| State(s) of Solicitation |
o |
All States |
| AZ CA CT FL HI IL ME MD MI NJ NY NC VA |
| Recipient |
Recipient CRD Number |
o |
None |
| Donald G. Dewaay Jr. |
1297174 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Dewaay Financial Network, LLC |
30767 |
| Street Address 1 |
Street Address 2 |
| 13001 University Avenue |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Clive |
IA |
50325 |
| State(s) of Solicitation |
o |
All States |
| AL AK AZ AR CA CO CT DC FL GA HI ID IL IN IA KS KY MA MI MN MO MT NE NV NM NY NC ND OH OK OR PA SC SD TX UT VT VA WA WI WY |
| Recipient |
Recipient CRD Number |
o |
None |
| Joshua E. Cross |
4522751 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Dewaay Financial Network, LLC |
30767 |
| Street Address 1 |
Street Address 2 |
| 13001 University Avenue |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Clive |
IA |
50325 |
| State(s) of Solicitation |
o |
All States |
| AL AZ FL HI IL IA KS KY MA MN MO NE NV NC OH TX WA WI |
| Recipient |
Recipient CRD Number |
o |
None |
| Michael D. Morrow |
2364423 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Dewaay Financial Network, LLC |
30767 |
| Street Address 1 |
Street Address 2 |
| 402 N. Carroll Ave., Suite 100 |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Southlake |
TX |
76092 |
| State(s) of Solicitation |
o |
All States |
| IL OK TX |
| Recipient |
Recipient CRD Number |
o |
None |
| H. Beck, Inc. |
1763 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| H. Beck, Inc. |
1763 |
| Street Address 1 |
Street Address 2 |
| 11140 Rockville Pike |
Suite 400 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Rockville |
MD |
20852 |
| State(s) of Solicitation |
o |
All States |
| AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA SC SD TN TX UT VT VA WA WI WY |
| Recipient |
Recipient CRD Number |
o |
None |
| Robert J. Steyert |
1122075 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Independent Financial Group, LLC |
7717 |
| Street Address 1 |
Street Address 2 |
| 30448 Rancho Viejo Road, No. 175 |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| San Juan Capistrano |
CA |
92675 |
| State(s) of Solicitation |
o |
All States |
| CA FL NJ NY UT WA |
| Recipient |
Recipient CRD Number |
o |
None |
| Lora J. Hoff |
3175071 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Investment Planners, Inc. |
18557 |
| Street Address 1 |
Street Address 2 |
| 10440 N. Central Expressway |
Suite 1040 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Dallas |
TX |
75231 |
| State(s) of Solicitation |
o |
All States |
| IA MN MO OK TX |
| Recipient |
Recipient CRD Number |
o |
None |
| LPL Financial Corporation |
6413 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| LPL Financial Corporation |
6413 |
| Street Address 1 |
Street Address 2 |
| One Beacon Street |
22nd Floor |
| City |
State/Province/Country |
ZIP/Postal Code |
| Boston |
MA |
02108 |
| State(s) of Solicitation |
o |
All States |
| AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA SC SD TN TX UT VT VA WA WI WY |
| Recipient |
Recipient CRD Number |
o |
None |
| Thomas J. Birch |
805540 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Mid Atlantic Capital Corporation |
10674 |
| Street Address 1 |
Street Address 2 |
| 1683 Novato Blvd. |
Suite 2 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Novato |
CA |
94949 |
| State(s) of Solicitation |
o |
All States |
| AZ CA GA ID MO OR |
| Recipient |
Recipient CRD Number |
o |
None |
| Leroy H. Nickels III |
813787 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Mutual Service Corporation |
4806 |
| Street Address 1 |
Street Address 2 |
| 2900 Bluecutt Road |
Suite 1 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Columbus |
MS |
39705 |
| State(s) of Solicitation |
o |
All States |
| AL AR CA CO FL GA ID IL LA MD MS NC OR TN TX |
| Recipient |
Recipient CRD Number |
o |
None |
| Daniel T. Hoban |
1095185 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Mutual Service Corporation |
4806 |
| Street Address 1 |
Street Address 2 |
| 1739 W. Big Beaver Road |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Troy |
MI |
48084 |
| State(s) of Solicitation |
o |
All States |
| AZ CA CO FL IL IN ME MA MI NV NC TN VA |
| Recipient |
Recipient CRD Number |
o |
None |
| Howard W. Minor, Jr. |
1008244 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Next Financial Group, Inc. |
46214 |
| Street Address 1 |
Street Address 2 |
| 413 Stuart Circle |
Suite 314 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Richmond |
VA |
23220 |
| State(s) of Solicitation |
o |
All States |
| FL MD NC VA |
| Recipient |
Recipient CRD Number |
o |
None |
| Timothy L. Baker |
1256333 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| NFP Securities, Inc. |
42046 |
| Street Address 1 |
Street Address 2 |
| 121 Reynolds Village |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Winston-Salem |
NC |
27106 |
| State(s) of Solicitation |
o |
All States |
| AZ CA CO FL GA IN IA KY NY NC OH PA SC TX VA |
| Recipient |
Recipient CRD Number |
o |
None |
| Kenneth R. Miller |
1009775 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| NFP Securities, Inc. |
42046 |
| Street Address 1 |
Street Address 2 |
| 701 Robley Drive |
Suite 101 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Lafayette |
LA |
70503 |
| State(s) of Solicitation |
o |
All States |
| AZ CA CO LA ME MS MT NE NY SC TX VA |
| Recipient |
Recipient CRD Number |
o |
None |
| Dennis L. Freeman |
213683 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Okoboji Financial Services, Inc. |
33727 |
| Street Address 1 |
Street Address 2 |
| 600 Fifth Street |
Suite 102 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Ames |
IA |
50010 |
| State(s) of Solicitation |
o |
All States |
| IA MN |
| Recipient |
Recipient CRD Number |
o |
None |
| Pacific West Securities, Inc. |
6390 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Pacific West Securities, Inc. |
6390 |
| Street Address 1 |
Street Address 2 |
| 555 S. Renton Village Pl |
Suite 700 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Renton |
WA |
98057 |
| State(s) of Solicitation |
o |
All States |
| AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA SC SD TN TX UT VT VA WA WI WY |
| Recipient |
Recipient CRD Number |
o |
None |
| QA3 Financial Corp. |
14754 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| QA3 Financial Corp. |
14754 |
| Street Address 1 |
Street Address 2 |
| One Valmont Plaza, 4th Floor |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Omaha |
NE |
68154 |
| State(s) of Solicitation |
o |
All States |
| AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA SC SD TN TX UT VT VA WA WI WY |
| Recipient |
Recipient CRD Number |
o |
None |
| Norman G. Price |
2406981 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| RP Capital LLC |
134768 |
| Street Address 1 |
Street Address 2 |
| 5202 Olympic Drive NW |
Suite 101 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Gig Harbor |
WA |
98335 |
| State(s) of Solicitation |
o |
All States |
| AL CA FL NV OR TX WA |
| Recipient |
Recipient CRD Number |
o |
None |
| Sagepoint Financial, Inc. |
133763 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Sagepoint Financial, Inc. |
133763 |
| Street Address 1 |
Street Address 2 |
| 2800 N. Central Ave., Ste 2100 |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Phoenix |
AZ |
85004 |
| State(s) of Solicitation |
o |
All States |
| AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA SC SD TN TX UT VT VA WA WI WY |
| Recipient |
Recipient CRD Number |
o |
None |
| Gregory L. Hutto |
2742911 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Silver Oak Securities, Incorporated |
46947 |
| Street Address 1 |
Street Address 2 |
| 512 Main Street |
Suite 1400 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Forth Worth |
TX |
76102 |
| State(s) of Solicitation |
o |
All States |
| OH TX WA |
| Recipient |
Recipient CRD Number |
o |
None |
| William E. Riley, Jr. |
1493287 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Silver Oak Securities, Incorporated |
46947 |
| Street Address 1 |
Street Address 2 |
| 512 Main Street |
Suite 1400 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Forth Worth |
TX |
76102 |
| State(s) of Solicitation |
o |
All States |
| TX |
| Recipient |
Recipient CRD Number |
o |
None |
| John T. Dunn |
2448503 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| The Strategic Financial Alliance, Inc. |
126514 |
| Street Address 1 |
Street Address 2 |
| 107 Weatherstone Drive |
Suite 520 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Woodstock |
GA |
30188 |
| State(s) of Solicitation |
o |
All States |
| CA FL GA IL LA PA SC VA |
| Recipient |
Recipient CRD Number |
o |
None |
| VSR Financial Services, Inc. |
14503 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| VSR Financial Services, Inc. |
14503 |
| Street Address 1 |
Street Address 2 |
| 8620 W 110th Street |
Suite 200 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Overland Park |
KS |
66210 |
| State(s) of Solicitation |
o |
All States |
| AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA SC SD TN TX UT VT VA WA WI WY |
| Recipient |
Recipient CRD Number |
o |
None |
| Jack Thomas |
2773136 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| AFA Financial Group, LLC |
127648 |
| Street Address 1 |
Street Address 2 |
| 26637 W. Agoura Rd. |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Calabasas |
CA |
91302 |
| State(s) of Solicitation |
o |
All States |
| CA ID |
| Recipient |
Recipient CRD Number |
o |
None |
| Jeffrey Rachlin |
823547 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Alternative Wealth Strategies, Inc. |
130933 |
| Street Address 1 |
Street Address 2 |
| 777 Old Saw Mill River Road |
Suite 240 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Tarrytown |
NY |
10591 |
| State(s) of Solicitation |
o |
All States |
| CT FL HI MD MA NJ NY |
| Recipient |
Recipient CRD Number |
o |
None |
| Drew A. Donohoe |
4504638 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Ameritas Investment Corp. |
14869 |
| Street Address 1 |
Street Address 2 |
| 8800 Lyra Drive |
Suite 680 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Columbus |
OH |
43240 |
| State(s) of Solicitation |
o |
All States |
| NV OH PA |
| Recipient |
Recipient CRD Number |
o |
None |
| Thomas H. Lawrence III |
1839619 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Ameritas Investment Corp. |
14869 |
| Street Address 1 |
Street Address 2 |
| 1755 N. Kirby Parkway |
Suite 300 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Memphis |
TN |
38120 |
| State(s) of Solicitation |
o |
All States |
| AR KY MS MO TN |
| Recipient |
Recipient CRD Number |
o |
None |
| Manuel E. Martinez |
840279 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Ameritas Investment Corp. |
14869 |
| Street Address 1 |
Street Address 2 |
| 325 West Third Ave. |
Suite 203 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Escondido |
CA |
92025 |
| State(s) of Solicitation |
o |
All States |
| CA CO FL |
| Recipient |
Recipient CRD Number |
o |
None |
| James D. Howard |
1777319 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Associated Securities Corp. |
12969 |
| Street Address 1 |
Street Address 2 |
| 421 West Riverside , Suite 1700 |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Spokane |
WA |
99201 |
| State(s) of Solicitation |
o |
All States |
| AZ CA CO FL ID MN MT NE NC OR TX UT WA |
| Recipient |
Recipient CRD Number |
o |
None |
| Sheri H. Pan |
4536152 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Associated Securities Corp. |
12969 |
| Street Address 1 |
Street Address 2 |
| 222 N. Sepulveda Blvd. |
18th Floor |
| City |
State/Province/Country |
ZIP/Postal Code |
| El Segundo |
CA |
90245 |
| State(s) of Solicitation |
o |
All States |
| CA CO |
| Recipient |
Recipient CRD Number |
o |
None |
| Richard L. Belline |
2432737 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Axa Advisors, LLC |
6627 |
| Street Address 1 |
Street Address 2 |
| 213 W. Monroe |
Suite Q |
| City |
State/Province/Country |
ZIP/Postal Code |
| Lowell |
AR |
72745 |
| State(s) of Solicitation |
o |
All States |
| AR CA CO FL GA IL KS LA MO NC OH OK TN TX |
| Recipient |
Recipient CRD Number |
o |
None |
| Daniel A. Barnard |
2403593 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Berthel, Fisher & Company Financial Services, Inc. |
13609 |
| Street Address 1 |
Street Address 2 |
| 8563 E. San Alberto Drive |
Suite 140 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Scottsdale |
AZ |
85258 |
| State(s) of Solicitation |
o |
All States |
| AZ CA CO FL IL IN IA NE NV VA |
| Recipient |
Recipient CRD Number |
o |
None |
| Steven L. Stahler |
1706697 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Berthel, Fisher & Company Financial Services, Inc. |
13609 |
| Street Address 1 |
Street Address 2 |
| 7660 Goodwood |
Suite A102 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Baton Rouge |
LA |
70806 |
| State(s) of Solicitation |
o |
All States |
| IL IA LA NC OR WI |
| Recipient |
Recipient CRD Number |
o |
None |
| Ty K. Bauer |
2150885 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Carlton & Associates, Inc. |
20999 |
| Street Address 1 |
Street Address 2 |
| 1223 E. Jackson Avenue |
#310 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Oxford |
MS |
38655 |
| State(s) of Solicitation |
o |
All States |
| AL CA CO CT GA IL IN LA MS MO NV NM NY PA TN TX |
| Recipient |
Recipient CRD Number |
o |
None |
| Burley A. Daye |
63064 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Centaurus Financial, Inc. |
30833 |
| Street Address 1 |
Street Address 2 |
| 533 Airport Blvd. |
Suite #219 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Burlingame |
CA |
94010 |
| State(s) of Solicitation |
o |
All States |
| CA NV UT |
| Recipient |
Recipient CRD Number |
o |
None |
| Daniel J. Stange |
2693826 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Crown Capital Securities, L.P. |
6312 |
| Street Address 1 |
Street Address 2 |
| 101 Main Street |
Suite 260 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Huntington Beach |
CA |
92648 |
| State(s) of Solicitation |
o |
All States |
| CA IN OR TX WA |
| Recipient |
Recipient CRD Number |
o |
None |
| Joseph M. Gatt |
218745 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Girard Securities, Inc. |
18697 |
| Street Address 1 |
Street Address 2 |
| 1455 East Tropicana Avenue |
Suite 275 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Las Vegas |
NV |
89119 |
| State(s) of Solicitation |
o |
All States |
| CA CO NV UT |
| Recipient |
Recipient CRD Number |
o |
None |
| Nathan C. Ankney |
2444651 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Independent Financial Group, LLC |
7717 |
| Street Address 1 |
Street Address 2 |
| 1541 The Alameda |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| San Jose |
CA |
95126 |
| State(s) of Solicitation |
o |
All States |
| CA OR |
| Recipient |
Recipient CRD Number |
o |
None |
| James B. Boyle |
5570142 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Independent Financial Group, LLC |
7717 |
| Street Address 1 |
Street Address 2 |
| 1541 The Alameda |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| San Jose |
CA |
95126 |
| State(s) of Solicitation |
o |
All States |
| CA OR |
| Recipient |
Recipient CRD Number |
o |
None |
| David R. Koehler |
4832628 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Independent Financial Group, LLC |
7717 |
| Street Address 1 |
Street Address 2 |
| 1541 The Alameda |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| San Jose |
CA |
95126 |
| State(s) of Solicitation |
o |
All States |
| CA NV OR |
| Recipient |
Recipient CRD Number |
o |
None |
| Morgan B. Nickels Mr. |
4921264 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Mutual Service Corporation |
4806 |
| Street Address 1 |
Street Address 2 |
| 2900 Bluecutt Road |
Suite 1 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Columbus |
MS |
39705 |
| State(s) of Solicitation |
o |
All States |
| AL MS OR |
| Recipient |
Recipient CRD Number |
o |
None |
| Edward T. Coda |
1776811 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| National Planning Corporation |
29604 |
| Street Address 1 |
Street Address 2 |
| 500 Alakawa St. |
Suite 220 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Honolulu |
HI |
96817 |
| State(s) of Solicitation |
o |
All States |
| AZ CA CO DE FL GA HI ID ME NV NM NY NC OH TN TX VA WA |
| Recipient |
Recipient CRD Number |
o |
None |
| Arthur J. Moss |
1409033 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| National Planning Corporation |
29604 |
| Street Address 1 |
Street Address 2 |
| 7135 E. Camelback Road |
Ste 230 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Scottsdale |
AZ |
85251 |
| State(s) of Solicitation |
o |
All States |
| AZ CA CO FL ID |
| Recipient |
Recipient CRD Number |
o |
None |
| Kurt C. Jackson |
2913769 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| NFP Securities, Inc. |
42046 |
| Street Address 1 |
Street Address 2 |
| 575 Price Street |
Suite 314 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Pismo Beach |
CA |
93449 |
| State(s) of Solicitation |
o |
All States |
| CA IL OH OR PA TX WA |
| Recipient |
Recipient CRD Number |
o |
None |
| Thomas P. Kroehle Jr. |
4388363 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| NFP Securities, Inc. |
42046 |
| Street Address 1 |
Street Address 2 |
| 3939 Beltline Road |
Suite 310 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Addison |
TX |
75001 |
| State(s) of Solicitation |
o |
All States |
| AR CO DC FL KY MD MA NY OH OK TX VA WA |
| Recipient |
Recipient CRD Number |
o |
None |
| John P. Hannan |
1372033 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Private Asset Group, Inc. |
142541 |
| Street Address 1 |
Street Address 2 |
| 62 E. Genesee Street |
3rd Floor |
| City |
State/Province/Country |
ZIP/Postal Code |
| Skaneateles |
NY |
13152 |
| State(s) of Solicitation |
o |
All States |
| CA FL HI MN NV NJ NM NY NC TX |
| Recipient |
Recipient CRD Number |
o |
None |
| Bradley J. Freimark |
2883389 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Proequities, Inc. |
15708 |
| Street Address 1 |
Street Address 2 |
| 9010 Quantrelle Ave NE |
Suite 107 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Otsego |
MN |
55330 |
| State(s) of Solicitation |
o |
All States |
| MD MN ND VA WI |
| Recipient |
Recipient CRD Number |
o |
None |
| Ronald D. Hershey |
4207119 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Proequities, Inc. |
15708 |
| Street Address 1 |
Street Address 2 |
| 809 Center Ave. |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Payette |
ID |
83661 |
| State(s) of Solicitation |
o |
All States |
| AZ CA ID MT OR |
| Recipient |
Recipient CRD Number |
o |
None |
| John P. Ochsner |
1502183 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Royal Alliance Associates, Inc. |
23131 |
| Street Address 1 |
Street Address 2 |
| 3217 West Smith Street |
Suite 2 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Seattle |
WA |
98199 |
| State(s) of Solicitation |
o |
All States |
| CA NH WA |
| Recipient |
Recipient CRD Number |
o |
None |
| David L. Goodman |
1429972 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Transam Securities, Inc. |
18923 |
| Street Address 1 |
Street Address 2 |
| 1111 Douglas Avenue |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Altamonte Springs |
FL |
32714 |
| State(s) of Solicitation |
o |
All States |
| AZ FL GA IN NC OH |
| Recipient |
Recipient CRD Number |
o |
None |
| Charles C. Shafe |
1277113 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Transam Securities, Inc. |
18923 |
| Street Address 1 |
Street Address 2 |
| 531 Versailles Drive |
Ste. 201 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Maitland |
FL |
32751 |
| State(s) of Solicitation |
o |
All States |
| FL |
| Recipient |
Recipient CRD Number |
o |
None |
| John R. Mickelson |
2628700 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Woodbury Financial Services, Inc. |
421 |
| Street Address 1 |
Street Address 2 |
| 40 W. Cache Valley Blvd. |
Suite 7A |
| City |
State/Province/Country |
ZIP/Postal Code |
| Logan |
UT |
84341 |
| State(s) of Solicitation |
o |
All States |
| CA ID IA UT |
| Recipient |
Recipient CRD Number |
o |
None |
| Michael J. Talin |
3121059 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Woodbury Financial Services, Inc. |
421 |
| Street Address 1 |
Street Address 2 |
| 3020 Old Ranch Parkway |
Ste. 300 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Seal Beach |
CA |
90740 |
| State(s) of Solicitation |
o |
All States |
| AZ CA CT MI NV WI |
| Recipient |
Recipient CRD Number |
o |
None |
| FSC Securities Corporation |
7461 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| FSA Securities Corporation |
7461 |
| Street Address 1 |
Street Address 2 |
| 2300 Windy Ridge Pkwy |
Suite 1100 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Atlanta |
GA |
30339 |
| State(s) of Solicitation |
o |
All States |
| AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA SC SD TN TX UT VT VA WA WI WY |
| Recipient |
Recipient CRD Number |
o |
None |
| Alex M. Negron |
3187717 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Proequities Inc. |
15708 |
| Street Address 1 |
Street Address 2 |
| 1400 W. Fairbanks Ave. |
Ste. 202 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Winter Park |
FL |
32789 |
| State(s) of Solicitation |
o |
All States |
| FL |
| Recipient |
Recipient CRD Number |
o |
None |
| Robert A. Horning |
2311640 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Direct Capital Securities, Inc. |
29639 |
| Street Address 1 |
Street Address 2 |
| 3 MacArthur Pl. |
Ste. 855 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Santa Ana |
CA |
92707 |
| State(s) of Solicitation |
o |
All States |
| CA |
| 13. Offering and Sales Amounts |
| Total Offering Amount |
$ 35000000 USD |
o Indefinite |
| Total Amount Sold |
$ 17123859 USD |
|
| Total Remaining to be Sold |
$ 17876141 USD |
o Indefinite |
| |
| Clarification of Response (if Necessary) |
| |
| o |
Select if securities in the offering have been or may be sold to persons who do not qualify as accredited investors,
Number of such non-accredited investors who already have invested in the offering |
|
| |
Regardless of whether securities in the offering have been or may be sold to persons who do not qualify as accredited investors, enter the total number of investors who already have invested in the offering: |
260 |
| 15. Sales Commissions & Finders' Fees Expenses |
| Provide separately the amounts of sales commissions and finders' fees expenses, if any. If the amount of an expenditure is not known, provide an estimate and check the box next to the amount. |
| Sales Commissions |
$ 2975000 USD |
x |
Estimate |
| Finders' Fees |
$ 0 USD |
o |
Estimate |
| |
| Clarification of Response (if Necessary) |
| |
| Provide the amount of the gross proceeds of the offering that has been or is proposed to be used for payments to any of the persons required to be named as executive officers, directors or promoters in response to Item 3 above. If the amount is unknown, provide an estimate and check the box next to the amount. |
| |
| Clarification of Response (if Necessary) |
| |
| Please verify the information you have entered and review the Terms of Submission below before signing and clicking SUBMIT below to file this notice. |
| Terms of Submission |
| |
In submitting this notice, each Issuer named above is: |
|
| |
- Notifying the SEC and/or each State in which this notice is filed of the offering of securities described and undertaking to furnish them, upon written request, the information furnished to offerees.
- Irrevocably appointing each of the Secretary of the SEC and, the Securities Administrator or other legally designated officer of the State in which the Issuer maintains its principal place of business and any State in which this notice is filed, as its agents for service of process, and agreeing that these persons may accept service on its behalf, of any notice, process or pleading, and further agreeing that such service may be made by registered or certified mail, in any Federal or state action, administrative proceeding, or arbitration brought against it in any place subject to the jurisdiction of the United States, if the action, proceeding or arbitration (a) arises out of any activity in connection with the offering of securities that is the subject of this notice, and (b) is founded, directly or indirectly, upon the provisions of: (i) the Securities Act of 1933, the Securities Exchange Act of 1934, the Trust Indenture Act of 1939, the Investment Company Act of 1940, or the Investment Advisers Act of 1940, or any rule or regulation under any of these statutes, or (ii) the laws of the State in which the issuer maintains its principal place of business or any State in which this notice is filed.
- Certifying that the Issuer is not disqualified from relying on any Regulation D exemption it has identified in Item 6 above for one of the reasons stated in Rule 505(b)(2)(iii).
|
|
| |
| |
Each Issuer identified above has read this notice, knows the contents to be true, and has duly caused this notice to be signed on its behalf by the undersigned duly authorized person. |
| |
For signature, type in the signer's name or other letters or characters adopted or authorized as the signer's signature. |
| Issuer |
Signature |
Name of Signer |
Title |
Date |
| Cypress Equipment Fund 16, LLC |
/s/ DANIEL RAEL |
Daniel Rael |
Vice President of Manager of Issuer |
2009-08-03 |
|
|
|
|
 |  |
|
|
| Re: Cypress Income Funds 1-9 |
|
|
|
|
UNITED STATES SECURITIES
AND EXCHANGE COMMISSION
Washington, D.C.
FORM D
|
OMB APPROVAL
OMB Number: 3235-0076
Expires: September 30, 2008
Estimated Average burden hours per response: 4.0
|
|
Notice of Exempt Offering of Securities
|
| |
| 1. Issuer's Identity |
| CIK (Filer ID Number) |
Previous Name(s) x None |
Entity Type |
|
0001451787
|
|
o Corporation
o Limited Partnership
x Limited Liability Company
o General Partnership
o Business Trust
o Other
|
| Name of Issuer |
|
Cypress Equipment Fund 16, LLC
|
| Jurisdiction of Incorporation/Organization |
| CALIFORNIA |
| |
| Year of Incorporation/Organization |
| |
o |
Over Five Years Ago |
| |
x |
Within Last Five Years (Specify Year) |
2008 |
| |
o |
Yet to Be Formed |
|
| 2. Principal Place of Business and Contact Information |
| Name of Issuer |
|
| Cypress Equipment Fund 16, LLC |
|
| Street Address 1 |
Street Address 2 |
| 188 The Embarcadero, Suite 420 |
|
| City |
State/Province/Country |
ZIP/Postal Code |
Phone No. of Issuer |
| San Francisco |
CA |
94105 |
415-281-3020 |
| Last Name |
First Name |
Middle Name |
| Harwood |
Stephen |
Rogers |
| Street Address 1 |
Street Address 2 |
| 188 The Embarcadero, Suite 420 |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| San Francisco |
CA |
94105 |
| Relationship: |
x |
Executive Officer |
x |
Director |
x |
Promoter |
| Clarification of Response (if Necessary) |
| |
Officer and Director of LLC Manager |
| Last Name |
First Name |
Middle Name |
| Cypress Equipment Management Corp IV |
NA |
|
| Street Address 1 |
Street Address 2 |
| 188 The Embarcadero, Suite 420 |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| San Francisco |
CA |
94105 |
| Relationship: |
x |
Executive Officer |
o |
Director |
x |
Promoter |
| Clarification of Response (if Necessary) |
| |
LLC Manager |
| Last Name |
First Name |
Middle Name |
| Park |
Kenneth |
|
| Street Address 1 |
Street Address 2 |
| 188 The Embarcadero, Suite 420 |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| San Francisco |
CA |
94105 |
| Relationship: |
x |
Executive Officer |
o |
Director |
o |
Promoter |
| Clarification of Response (if Necessary) |
| |
Officer of LLC Manager |
| Last Name |
First Name |
Middle Name |
| Rael |
Daniel |
|
| Street Address 1 |
Street Address 2 |
| 188 The Embarcadero, Suite 420 |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| San Francisco |
CA |
94105 |
| Relationship: |
x |
Executive Officer |
o |
Director |
o |
Promoter |
| Clarification of Response (if Necessary) |
| |
Officer of LLC Manager |
| o |
Agriculture |
|
Health Care |
o |
Retailing |
| |
Banking & Financial Services |
|
o |
Biotechnology |
o |
Restaurants |
| |
o |
Commercial Banking |
|
o |
Health Insurance |
|
Technology |
| |
o |
Insurance |
|
o |
Hospitals & Physicians |
|
o |
Computers |
| |
o |
Investing |
|
o |
Pharmaceuticals |
|
o |
Telecommunications |
| |
o |
Investment Banking |
|
o |
Other Health Care |
|
o |
Other Technology |
| |
o |
Pooled Investment Fund
|
|
|
|
|
Travel |
| |
x |
Other Banking & Financial Services |
o |
Manufacturing |
|
o |
Airlines & Airports |
| |
Real Estate |
|
o |
Lodging & Conventions |
| |
o |
Commercial |
|
o |
Tourism & Travel Services |
| |
o |
Construction |
|
o |
Other Travel |
| |
o |
REITS & Finance |
o |
Other |
| |
o |
Residential |
|
| |
o |
Other Real Estate |
|
| o |
Business Services |
|
| |
Energy |
|
| |
o |
Coal Mining |
|
| |
o |
Electric Utilities |
|
| |
o |
Energy Conservation |
|
| |
o |
Environmental Services |
|
| |
o |
Oil & Gas |
|
| |
o |
Other Energy |
|
| Revenue Range |
Aggregate Net Asset Value Range |
| o |
No Revenues |
o |
No Aggregate Net Asset Value |
| o |
$1 - $1,000,000 |
o |
$1 - $5,000,000 |
| o |
$1,000,001 - $5,000,000 |
o |
$5,000,001 - $25,000,000 |
| o |
$5,000,001 - $25,000,000 |
o |
$25,000,001 - $50,000,000 |
| o |
$25,000,001 - $100,000,000 |
o |
$50,000,001 - $100,000,000 |
| o |
Over $100,000,000 |
o |
Over $100,000,000 |
| x |
Decline to Disclose |
o |
Decline to Disclose |
| o |
Not Applicable |
o |
Not Applicable |
| 6. Federal Exemption(s) and Exclusion(s) Claimed (select all that apply) |
| o |
Rule 504(b)(1) (not (i), (ii) or (iii)) |
o |
Rule 505 |
| o |
Rule 504 (b)(1)(i) |
x |
Rule 506 |
| o |
Rule 504 (b)(1)(ii) |
o |
Securities Act Section 4(6) |
| o |
Rule 504 (b)(1)(iii) |
o |
Investment Company Act Section 3(c) |
| o |
New Notice |
Date of First Sale |
2009-01-07 |
o |
First Sale Yet to Occur |
| Does the Issuer intend this offering to last more than one year? |
x |
Yes |
o |
No |
| 9. Type(s) of Securities Offered (select all that apply) |
| o |
Pooled Investment Fund Interests |
x |
Equity |
| o |
Tenant-in-Common Securities |
o |
Debt |
| o |
Mineral Property Securities |
o |
Option, Warrant or Other Right to Acquire Another Security |
| o |
Security to be Acquired Upon Exercise of Option, Warrant or Other Right to Acquire Security |
o |
Other (describe) |
| |
|
| 10. Business Combination Transaction |
| Is this offering being made in connection with a business combination transaction, such as a merger, acquisition or exchange offer? |
o |
Yes |
x |
No |
| |
| Clarification of Response (if Necessary) |
|
| |
| Minimum investment accepted from any outside investor |
$ 35000 USD |
| Recipient |
Recipient CRD Number |
o |
None |
| Cypress Capital Corporation |
42681 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Cypress Capital Corporation |
42681 |
| Street Address 1 |
Street Address 2 |
| 188 The Embarcader, Suite 420 |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| San Francisco |
CA |
94105 |
| State(s) of Solicitation |
o |
All States |
| AZ AR CA CO CT DC FL GA HI ID IL IN IA KS KY LA MD MA MI MN MO NE NV NJ NY NC OH OR PA SC TN TX UT VT VA WA WI |
| Recipient |
Recipient CRD Number |
o |
None |
| Michael L. Staines, Jr. |
5303142 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Berthel, Fisher and Company Financial Services, Inc. |
13609 |
| Street Address 1 |
Street Address 2 |
| 300 Harding Blvd. |
Suite 209 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Roseville |
CA |
95678 |
| State(s) of Solicitation |
o |
All States |
| AZ CA NJ NY PA TX |
| Recipient |
Recipient CRD Number |
o |
None |
| Zachary L. Carey |
3110546 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Calton and Associates, Inc. |
20999 |
| Street Address 1 |
Street Address 2 |
| 1223 E. Jackson Ave. |
Suite 301 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Oxford |
MS |
38655 |
| State(s) of Solicitation |
o |
All States |
| AL AR FL GA KY LA MS TN TX VA |
| Recipient |
Recipient CRD Number |
o |
None |
| Oliver B. Williamson |
4642029 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Calton and Associates, Inc. |
20999 |
| Street Address 1 |
Street Address 2 |
| 611 Hambley Blvd. |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Pikeville |
KY |
41501 |
| State(s) of Solicitation |
o |
All States |
| FL IN KY MA NY NC OH SC TN VA |
| Recipient |
Recipient CRD Number |
o |
None |
| Phillip D. King |
1839137 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Calton and Associates, Inc. |
20999 |
| Street Address 1 |
Street Address 2 |
| 611 Hambley Blvd. |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Pikeville |
KY |
41501 |
| State(s) of Solicitation |
o |
All States |
| CA FL GA IN KY MI NC OH SC TN VA |
| Recipient |
Recipient CRD Number |
o |
None |
| Maryellen Trotter |
862519 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Centaurus Financial, Inc. |
30833 |
| Street Address 1 |
Street Address 2 |
| 1515 E. Cedar Avenue |
Suite C5 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Flagstaff |
AZ |
86004 |
| State(s) of Solicitation |
o |
All States |
| AZ CA CO FL GA MS NV NM PA |
| Recipient |
Recipient CRD Number |
o |
None |
| Bryan D. Myers |
2527480 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Chapin, Davis |
28116 |
| Street Address 1 |
Street Address 2 |
| 2 Village Square, Suite 200 |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Baltimore |
MD |
21210 |
| State(s) of Solicitation |
o |
All States |
| MD VA |
| Recipient |
Recipient CRD Number |
o |
None |
| Edward W. Grogan IV |
2344994 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Commonwealth Financial Network |
8032 |
| Street Address 1 |
Street Address 2 |
| 6625 Wagner Way NW |
Suite 320 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Gig Harbor |
WA |
98335 |
| State(s) of Solicitation |
o |
All States |
| AK AZ CA CO CT DC FL HI ID KY MD MI MN MT NE NH NY OR SC TX WA WI |
| Recipient |
Recipient CRD Number |
o |
None |
| Robert E. Leib |
1267444 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Commonwealth Financial Network |
8032 |
| Street Address 1 |
Street Address 2 |
| 101 West Elm Street |
Suite 500 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Conshohocken |
PA |
19428 |
| State(s) of Solicitation |
o |
All States |
| CA DE FL IL MD NJ NY NC PA VA |
| Recipient |
Recipient CRD Number |
o |
None |
| Joseph L. England |
2934344 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Commonwealth Financial Network |
8032 |
| Street Address 1 |
Street Address 2 |
| 101 West Elm Street |
Suite 500 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Conshohocken |
PA |
19428 |
| State(s) of Solicitation |
o |
All States |
| DE IN NJ PA |
| Recipient |
Recipient CRD Number |
o |
None |
| Stephen A. Catania |
2389489 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Crown Capital Securities, L.P. |
6312 |
| Street Address 1 |
Street Address 2 |
| 725 Town and Country Road |
Suite 530 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Orange |
CA |
92868 |
| State(s) of Solicitation |
o |
All States |
| GA IL TN VA |
| Recipient |
Recipient CRD Number |
o |
None |
| Melissa C. Mather |
4697533 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Crown Capital Securities, L.P. |
6312 |
| Street Address 1 |
Street Address 2 |
| 1756 Grain Mill Road |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| San Marcos |
CA |
92078 |
| State(s) of Solicitation |
o |
All States |
| CA |
| Recipient |
Recipient CRD Number |
o |
None |
| David B. McMillen |
1198070 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Crown Capital Securities, L.P. |
6312 |
| Street Address 1 |
Street Address 2 |
| 106 Pineview Lane |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Boulder |
CO |
80302 |
| State(s) of Solicitation |
o |
All States |
| CA CO ID OR |
| Recipient |
Recipient CRD Number |
o |
None |
| David A. Harris |
500413 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| David Harris and Co., Inc. |
45670 |
| Street Address 1 |
Street Address 2 |
| 222 Mamaroneck Avenue |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| White Plains |
NY |
10605 |
| State(s) of Solicitation |
o |
All States |
| AZ CA CT FL HI IL ME MD MI NJ NY NC VA |
| Recipient |
Recipient CRD Number |
o |
None |
| Donald G. Dewaay Jr. |
1297174 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Dewaay Financial Network, LLC |
30767 |
| Street Address 1 |
Street Address 2 |
| 13001 University Avenue |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Clive |
IA |
50325 |
| State(s) of Solicitation |
o |
All States |
| AL AK AZ AR CA CO CT DC FL GA HI ID IL IN IA KS KY MA MI MN MO MT NE NV NM NY NC ND OH OK OR PA SC SD TX UT VT VA WA WI WY |
| Recipient |
Recipient CRD Number |
o |
None |
| Joshua E. Cross |
4522751 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Dewaay Financial Network, LLC |
30767 |
| Street Address 1 |
Street Address 2 |
| 13001 University Avenue |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Clive |
IA |
50325 |
| State(s) of Solicitation |
o |
All States |
| AL AZ FL HI IL IA KS KY MA MN MO NE NV NC OH TX WA WI |
| Recipient |
Recipient CRD Number |
o |
None |
| Michael D. Morrow |
2364423 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Dewaay Financial Network, LLC |
30767 |
| Street Address 1 |
Street Address 2 |
| 402 N. Carroll Ave., Suite 100 |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Southlake |
TX |
76092 |
| State(s) of Solicitation |
o |
All States |
| IL OK TX |
| Recipient |
Recipient CRD Number |
o |
None |
| H. Beck, Inc. |
1763 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| H. Beck, Inc. |
1763 |
| Street Address 1 |
Street Address 2 |
| 11140 Rockville Pike |
Suite 400 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Rockville |
MD |
20852 |
| State(s) of Solicitation |
o |
All States |
| AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA SC SD TN TX UT VT VA WA WI WY |
| Recipient |
Recipient CRD Number |
o |
None |
| Robert J. Steyert |
1122075 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Independent Financial Group, LLC |
7717 |
| Street Address 1 |
Street Address 2 |
| 30448 Rancho Viejo Road, No. 175 |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| San Juan Capistrano |
CA |
92675 |
| State(s) of Solicitation |
o |
All States |
| CA FL NJ NY UT WA |
| Recipient |
Recipient CRD Number |
o |
None |
| Lora J. Hoff |
3175071 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Investment Planners, Inc. |
18557 |
| Street Address 1 |
Street Address 2 |
| 10440 N. Central Expressway |
Suite 1040 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Dallas |
TX |
75231 |
| State(s) of Solicitation |
o |
All States |
| IA MN MO OK TX |
| Recipient |
Recipient CRD Number |
o |
None |
| LPL Financial Corporation |
6413 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| LPL Financial Corporation |
6413 |
| Street Address 1 |
Street Address 2 |
| One Beacon Street |
22nd Floor |
| City |
State/Province/Country |
ZIP/Postal Code |
| Boston |
MA |
02108 |
| State(s) of Solicitation |
o |
All States |
| AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA SC SD TN TX UT VT VA WA WI WY |
| Recipient |
Recipient CRD Number |
o |
None |
| Thomas J. Birch |
805540 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Mid Atlantic Capital Corporation |
10674 |
| Street Address 1 |
Street Address 2 |
| 1683 Novato Blvd. |
Suite 2 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Novato |
CA |
94949 |
| State(s) of Solicitation |
o |
All States |
| AZ CA GA ID MO OR |
| Recipient |
Recipient CRD Number |
o |
None |
| Leroy H. Nickels III |
813787 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Mutual Service Corporation |
4806 |
| Street Address 1 |
Street Address 2 |
| 2900 Bluecutt Road |
Suite 1 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Columbus |
MS |
39705 |
| State(s) of Solicitation |
o |
All States |
| AL AR CA CO FL GA ID IL LA MD MS NC OR TN TX |
| Recipient |
Recipient CRD Number |
o |
None |
| Daniel T. Hoban |
1095185 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Mutual Service Corporation |
4806 |
| Street Address 1 |
Street Address 2 |
| 1739 W. Big Beaver Road |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Troy |
MI |
48084 |
| State(s) of Solicitation |
o |
All States |
| AZ CA CO FL IL IN ME MA MI NV NC TN VA |
| Recipient |
Recipient CRD Number |
o |
None |
| Howard W. Minor, Jr. |
1008244 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Next Financial Group, Inc. |
46214 |
| Street Address 1 |
Street Address 2 |
| 413 Stuart Circle |
Suite 314 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Richmond |
VA |
23220 |
| State(s) of Solicitation |
o |
All States |
| FL MD NC VA |
| Recipient |
Recipient CRD Number |
o |
None |
| Timothy L. Baker |
1256333 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| NFP Securities, Inc. |
42046 |
| Street Address 1 |
Street Address 2 |
| 121 Reynolds Village |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Winston-Salem |
NC |
27106 |
| State(s) of Solicitation |
o |
All States |
| AZ CA CO FL GA IN IA KY NY NC OH PA SC TX VA |
| Recipient |
Recipient CRD Number |
o |
None |
| Kenneth R. Miller |
1009775 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| NFP Securities, Inc. |
42046 |
| Street Address 1 |
Street Address 2 |
| 701 Robley Drive |
Suite 101 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Lafayette |
LA |
70503 |
| State(s) of Solicitation |
o |
All States |
| AZ CA CO LA ME MS MT NE NY SC TX VA |
| Recipient |
Recipient CRD Number |
o |
None |
| Dennis L. Freeman |
213683 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Okoboji Financial Services, Inc. |
33727 |
| Street Address 1 |
Street Address 2 |
| 600 Fifth Street |
Suite 102 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Ames |
IA |
50010 |
| State(s) of Solicitation |
o |
All States |
| IA MN |
| Recipient |
Recipient CRD Number |
o |
None |
| Pacific West Securities, Inc. |
6390 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Pacific West Securities, Inc. |
6390 |
| Street Address 1 |
Street Address 2 |
| 555 S. Renton Village Pl |
Suite 700 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Renton |
WA |
98057 |
| State(s) of Solicitation |
o |
All States |
| AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA SC SD TN TX UT VT VA WA WI WY |
| Recipient |
Recipient CRD Number |
o |
None |
| QA3 Financial Corp. |
14754 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| QA3 Financial Corp. |
14754 |
| Street Address 1 |
Street Address 2 |
| One Valmont Plaza, 4th Floor |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Omaha |
NE |
68154 |
| State(s) of Solicitation |
o |
All States |
| AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA SC SD TN TX UT VT VA WA WI WY |
| Recipient |
Recipient CRD Number |
o |
None |
| Norman G. Price |
2406981 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| RP Capital LLC |
134768 |
| Street Address 1 |
Street Address 2 |
| 5202 Olympic Drive NW |
Suite 101 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Gig Harbor |
WA |
98335 |
| State(s) of Solicitation |
o |
All States |
| AL CA FL NV OR TX WA |
| Recipient |
Recipient CRD Number |
o |
None |
| Sagepoint Financial, Inc. |
133763 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Sagepoint Financial, Inc. |
133763 |
| Street Address 1 |
Street Address 2 |
| 2800 N. Central Ave., Ste 2100 |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Phoenix |
AZ |
85004 |
| State(s) of Solicitation |
o |
All States |
| AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA SC SD TN TX UT VT VA WA WI WY |
| Recipient |
Recipient CRD Number |
o |
None |
| Gregory L. Hutto |
2742911 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Silver Oak Securities, Incorporated |
46947 |
| Street Address 1 |
Street Address 2 |
| 512 Main Street |
Suite 1400 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Forth Worth |
TX |
76102 |
| State(s) of Solicitation |
o |
All States |
| OH TX WA |
| Recipient |
Recipient CRD Number |
o |
None |
| William E. Riley, Jr. |
1493287 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Silver Oak Securities, Incorporated |
46947 |
| Street Address 1 |
Street Address 2 |
| 512 Main Street |
Suite 1400 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Forth Worth |
TX |
76102 |
| State(s) of Solicitation |
o |
All States |
| TX |
| Recipient |
Recipient CRD Number |
o |
None |
| John T. Dunn |
2448503 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| The Strategic Financial Alliance, Inc. |
126514 |
| Street Address 1 |
Street Address 2 |
| 107 Weatherstone Drive |
Suite 520 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Woodstock |
GA |
30188 |
| State(s) of Solicitation |
o |
All States |
| CA FL GA IL LA PA SC VA |
| Recipient |
Recipient CRD Number |
o |
None |
| VSR Financial Services, Inc. |
14503 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| VSR Financial Services, Inc. |
14503 |
| Street Address 1 |
Street Address 2 |
| 8620 W 110th Street |
Suite 200 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Overland Park |
KS |
66210 |
| State(s) of Solicitation |
o |
All States |
| AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA SC SD TN TX UT VT VA WA WI WY |
| Recipient |
Recipient CRD Number |
o |
None |
| Jack Thomas |
2773136 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| AFA Financial Group, LLC |
127648 |
| Street Address 1 |
Street Address 2 |
| 26637 W. Agoura Rd. |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Calabasas |
CA |
91302 |
| State(s) of Solicitation |
o |
All States |
| CA ID |
| Recipient |
Recipient CRD Number |
o |
None |
| Jeffrey Rachlin |
823547 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Alternative Wealth Strategies, Inc. |
130933 |
| Street Address 1 |
Street Address 2 |
| 777 Old Saw Mill River Road |
Suite 240 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Tarrytown |
NY |
10591 |
| State(s) of Solicitation |
o |
All States |
| CT FL HI MD MA NJ NY |
| Recipient |
Recipient CRD Number |
o |
None |
| Drew A. Donohoe |
4504638 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Ameritas Investment Corp. |
14869 |
| Street Address 1 |
Street Address 2 |
| 8800 Lyra Drive |
Suite 680 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Columbus |
OH |
43240 |
| State(s) of Solicitation |
o |
All States |
| NV OH PA |
| Recipient |
Recipient CRD Number |
o |
None |
| Thomas H. Lawrence III |
1839619 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Ameritas Investment Corp. |
14869 |
| Street Address 1 |
Street Address 2 |
| 1755 N. Kirby Parkway |
Suite 300 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Memphis |
TN |
38120 |
| State(s) of Solicitation |
o |
All States |
| AR KY MS MO TN |
| Recipient |
Recipient CRD Number |
o |
None |
| Manuel E. Martinez |
840279 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Ameritas Investment Corp. |
14869 |
| Street Address 1 |
Street Address 2 |
| 325 West Third Ave. |
Suite 203 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Escondido |
CA |
92025 |
| State(s) of Solicitation |
o |
All States |
| CA CO FL |
| Recipient |
Recipient CRD Number |
o |
None |
| James D. Howard |
1777319 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Associated Securities Corp. |
12969 |
| Street Address 1 |
Street Address 2 |
| 421 West Riverside , Suite 1700 |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Spokane |
WA |
99201 |
| State(s) of Solicitation |
o |
All States |
| AZ CA CO FL ID MN MT NE NC OR TX UT WA |
| Recipient |
Recipient CRD Number |
o |
None |
| Sheri H. Pan |
4536152 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Associated Securities Corp. |
12969 |
| Street Address 1 |
Street Address 2 |
| 222 N. Sepulveda Blvd. |
18th Floor |
| City |
State/Province/Country |
ZIP/Postal Code |
| El Segundo |
CA |
90245 |
| State(s) of Solicitation |
o |
All States |
| CA CO |
| Recipient |
Recipient CRD Number |
o |
None |
| Richard L. Belline |
2432737 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Axa Advisors, LLC |
6627 |
| Street Address 1 |
Street Address 2 |
| 213 W. Monroe |
Suite Q |
| City |
State/Province/Country |
ZIP/Postal Code |
| Lowell |
AR |
72745 |
| State(s) of Solicitation |
o |
All States |
| AR CA CO FL GA IL KS LA MO NC OH OK TN TX |
| Recipient |
Recipient CRD Number |
o |
None |
| Daniel A. Barnard |
2403593 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Berthel, Fisher & Company Financial Services, Inc. |
13609 |
| Street Address 1 |
Street Address 2 |
| 8563 E. San Alberto Drive |
Suite 140 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Scottsdale |
AZ |
85258 |
| State(s) of Solicitation |
o |
All States |
| AZ CA CO FL IL IN IA NE NV VA |
| Recipient |
Recipient CRD Number |
o |
None |
| Steven L. Stahler |
1706697 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Berthel, Fisher & Company Financial Services, Inc. |
13609 |
| Street Address 1 |
Street Address 2 |
| 7660 Goodwood |
Suite A102 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Baton Rouge |
LA |
70806 |
| State(s) of Solicitation |
o |
All States |
| IL IA LA NC OR WI |
| Recipient |
Recipient CRD Number |
o |
None |
| Ty K. Bauer |
2150885 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Carlton & Associates, Inc. |
20999 |
| Street Address 1 |
Street Address 2 |
| 1223 E. Jackson Avenue |
#310 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Oxford |
MS |
38655 |
| State(s) of Solicitation |
o |
All States |
| AL CA CO CT GA IL IN LA MS MO NV NM NY PA TN TX |
| Recipient |
Recipient CRD Number |
o |
None |
| Burley A. Daye |
63064 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Centaurus Financial, Inc. |
30833 |
| Street Address 1 |
Street Address 2 |
| 533 Airport Blvd. |
Suite #219 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Burlingame |
CA |
94010 |
| State(s) of Solicitation |
o |
All States |
| CA NV UT |
| Recipient |
Recipient CRD Number |
o |
None |
| Daniel J. Stange |
2693826 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Crown Capital Securities, L.P. |
6312 |
| Street Address 1 |
Street Address 2 |
| 101 Main Street |
Suite 260 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Huntington Beach |
CA |
92648 |
| State(s) of Solicitation |
o |
All States |
| CA IN OR TX WA |
| Recipient |
Recipient CRD Number |
o |
None |
| Joseph M. Gatt |
218745 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Girard Securities, Inc. |
18697 |
| Street Address 1 |
Street Address 2 |
| 1455 East Tropicana Avenue |
Suite 275 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Las Vegas |
NV |
89119 |
| State(s) of Solicitation |
o |
All States |
| CA CO NV UT |
| Recipient |
Recipient CRD Number |
o |
None |
| Nathan C. Ankney |
2444651 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Independent Financial Group, LLC |
7717 |
| Street Address 1 |
Street Address 2 |
| 1541 The Alameda |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| San Jose |
CA |
95126 |
| State(s) of Solicitation |
o |
All States |
| CA OR |
| Recipient |
Recipient CRD Number |
o |
None |
| James B. Boyle |
5570142 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Independent Financial Group, LLC |
7717 |
| Street Address 1 |
Street Address 2 |
| 1541 The Alameda |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| San Jose |
CA |
95126 |
| State(s) of Solicitation |
o |
All States |
| CA OR |
| Recipient |
Recipient CRD Number |
o |
None |
| David R. Koehler |
4832628 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Independent Financial Group, LLC |
7717 |
| Street Address 1 |
Street Address 2 |
| 1541 The Alameda |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| San Jose |
CA |
95126 |
| State(s) of Solicitation |
o |
All States |
| CA NV OR |
| Recipient |
Recipient CRD Number |
o |
None |
| Morgan B. Nickels Mr. |
4921264 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Mutual Service Corporation |
4806 |
| Street Address 1 |
Street Address 2 |
| 2900 Bluecutt Road |
Suite 1 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Columbus |
MS |
39705 |
| State(s) of Solicitation |
o |
All States |
| AL MS OR |
| Recipient |
Recipient CRD Number |
o |
None |
| Edward T. Coda |
1776811 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| National Planning Corporation |
29604 |
| Street Address 1 |
Street Address 2 |
| 500 Alakawa St. |
Suite 220 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Honolulu |
HI |
96817 |
| State(s) of Solicitation |
o |
All States |
| AZ CA CO DE FL GA HI ID ME NV NM NY NC OH TN TX VA WA |
| Recipient |
Recipient CRD Number |
o |
None |
| Arthur J. Moss |
1409033 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| National Planning Corporation |
29604 |
| Street Address 1 |
Street Address 2 |
| 7135 E. Camelback Road |
Ste 230 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Scottsdale |
AZ |
85251 |
| State(s) of Solicitation |
o |
All States |
| AZ CA CO FL ID |
| Recipient |
Recipient CRD Number |
o |
None |
| Kurt C. Jackson |
2913769 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| NFP Securities, Inc. |
42046 |
| Street Address 1 |
Street Address 2 |
| 575 Price Street |
Suite 314 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Pismo Beach |
CA |
93449 |
| State(s) of Solicitation |
o |
All States |
| CA IL OH OR PA TX WA |
| Recipient |
Recipient CRD Number |
o |
None |
| Thomas P. Kroehle Jr. |
4388363 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| NFP Securities, Inc. |
42046 |
| Street Address 1 |
Street Address 2 |
| 3939 Beltline Road |
Suite 310 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Addison |
TX |
75001 |
| State(s) of Solicitation |
o |
All States |
| AR CO DC FL KY MD MA NY OH OK TX VA WA |
| Recipient |
Recipient CRD Number |
o |
None |
| John P. Hannan |
1372033 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Private Asset Group, Inc. |
142541 |
| Street Address 1 |
Street Address 2 |
| 62 E. Genesee Street |
3rd Floor |
| City |
State/Province/Country |
ZIP/Postal Code |
| Skaneateles |
NY |
13152 |
| State(s) of Solicitation |
o |
All States |
| CA FL HI MN NV NJ NM NY NC TX |
| Recipient |
Recipient CRD Number |
o |
None |
| Bradley J. Freimark |
2883389 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Proequities, Inc. |
15708 |
| Street Address 1 |
Street Address 2 |
| 9010 Quantrelle Ave NE |
Suite 107 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Otsego |
MN |
55330 |
| State(s) of Solicitation |
o |
All States |
| MD MN ND VA WI |
| Recipient |
Recipient CRD Number |
o |
None |
| Ronald D. Hershey |
4207119 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Proequities, Inc. |
15708 |
| Street Address 1 |
Street Address 2 |
| 809 Center Ave. |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Payette |
ID |
83661 |
| State(s) of Solicitation |
o |
All States |
| AZ CA ID MT OR |
| Recipient |
Recipient CRD Number |
o |
None |
| John P. Ochsner |
1502183 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Royal Alliance Associates, Inc. |
23131 |
| Street Address 1 |
Street Address 2 |
| 3217 West Smith Street |
Suite 2 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Seattle |
WA |
98199 |
| State(s) of Solicitation |
o |
All States |
| CA NH WA |
| Recipient |
Recipient CRD Number |
o |
None |
| David L. Goodman |
1429972 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Transam Securities, Inc. |
18923 |
| Street Address 1 |
Street Address 2 |
| 1111 Douglas Avenue |
|
| City |
State/Province/Country |
ZIP/Postal Code |
| Altamonte Springs |
FL |
32714 |
| State(s) of Solicitation |
o |
All States |
| AZ FL GA IN NC OH |
| Recipient |
Recipient CRD Number |
o |
None |
| Charles C. Shafe |
1277113 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Transam Securities, Inc. |
18923 |
| Street Address 1 |
Street Address 2 |
| 531 Versailles Drive |
Ste. 201 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Maitland |
FL |
32751 |
| State(s) of Solicitation |
o |
All States |
| FL |
| Recipient |
Recipient CRD Number |
o |
None |
| John R. Mickelson |
2628700 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Woodbury Financial Services, Inc. |
421 |
| Street Address 1 |
Street Address 2 |
| 40 W. Cache Valley Blvd. |
Suite 7A |
| City |
State/Province/Country |
ZIP/Postal Code |
| Logan |
UT |
84341 |
| State(s) of Solicitation |
o |
All States |
| CA ID IA UT |
| Recipient |
Recipient CRD Number |
o |
None |
| Michael J. Talin |
3121059 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Woodbury Financial Services, Inc. |
421 |
| Street Address 1 |
Street Address 2 |
| 3020 Old Ranch Parkway |
Ste. 300 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Seal Beach |
CA |
90740 |
| State(s) of Solicitation |
o |
All States |
| AZ CA CT MI NV WI |
| Recipient |
Recipient CRD Number |
o |
None |
| FSC Securities Corporation |
7461 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| FSA Securities Corporation |
7461 |
| Street Address 1 |
Street Address 2 |
| 2300 Windy Ridge Pkwy |
Suite 1100 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Atlanta |
GA |
30339 |
| State(s) of Solicitation |
o |
All States |
| AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA SC SD TN TX UT VT VA WA WI WY |
| Recipient |
Recipient CRD Number |
o |
None |
| Alex M. Negron |
3187717 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Proequities Inc. |
15708 |
| Street Address 1 |
Street Address 2 |
| 1400 W. Fairbanks Ave. |
Ste. 202 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Winter Park |
FL |
32789 |
| State(s) of Solicitation |
o |
All States |
| FL |
| Recipient |
Recipient CRD Number |
o |
None |
| Robert A. Horning |
2311640 |
| (Associated) Broker or Dealer |
o |
None |
(Associated) Broker or Dealer CRD Number |
o |
None |
| Direct Capital Securities, Inc. |
29639 |
| Street Address 1 |
Street Address 2 |
| 3 MacArthur Pl. |
Ste. 855 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Santa Ana |
CA |
92707 |
| State(s) of Solicitation |
o |
All States |
| CA |
| 13. Offering and Sales Amounts |
| Total Offering Amount |
$ 35000000 USD |
o Indefinite |
| Total Amount Sold |
$ 17123859 USD |
|
| Total Remaining to be Sold |
$ 17876141 USD |
o Indefinite |
| |
| Clarification of Response (if Necessary) |
| |
| o |
Select if securities in the offering have been or may be sold to persons who do not qualify as accredited investors,
Number of such non-accredited investors who already have invested in the offering |
|
| |
Regardless of whether securities in the offering have been or may be sold to persons who do not qualify as accredited investors, enter the total number of investors who already have invested in the offering: |
260 |
| 15. Sales Commissions & Finders' Fees Expenses |
| Provide separately the amounts of sales commissions and finders' fees expenses, if any. If the amount of an expenditure is not known, provide an estimate and check the box next to the amount. |
| Sales Commissions |
$ 2975000 USD |
x |
Estimate |
| Finders' Fees |
$ 0 USD |
o |
Estimate |
| |
| Clarification of Response (if Necessary) |
| |
| Provide the amount of the gross proceeds of the offering that has been or is proposed to be used for payments to any of the persons required to be named as executive officers, directors or promoters in response to Item 3 above. If the amount is unknown, provide an estimate and check the box next to the amount. |
| |
| Clarification of Response (if Necessary) |
| |
| Please verify the information you have entered and review the Terms of Submission below before signing and clicking SUBMIT below to file this notice. |
| Terms of Submission |
| |
In submitting this notice, each Issuer named above is: |
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- Notifying the SEC and/or each State in which this notice is filed of the offering of securities described and undertaking to furnish them, upon written request, the information furnished to offerees.
- Irrevocably appointing each of the Secretary of the SEC and, the Securities Administrator or other legally designated officer of the State in which the Issuer maintains its principal place of business and any State in which this notice is filed, as its agents for service of process, and agreeing that these persons may accept service on its behalf, of any notice, process or pleading, and further agreeing that such service may be made by registered or certified mail, in any Federal or state action, administrative proceeding, or arbitration brought against it in any place subject to the jurisdiction of the United States, if the action, proceeding or arbitration (a) arises out of any activity in connection with the offering of securities that is the subject of this notice, and (b) is founded, directly or indirectly, upon the provisions of: (i) the Securities Act of 1933, the Securities Exchange Act of 1934, the Trust Indenture Act of 1939, the Investment Company Act of 1940, or the Investment Advisers Act of 1940, or any rule or regulation under any of these statutes, or (ii) the laws of the State in which the issuer maintains its principal place of business or any State in which this notice is filed.
- Certifying that the Issuer is not disqualified from relying on any Regulation D exemption it has identified in Item 6 above for one of the reasons stated in Rule 505(b)(2)(iii).
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Each Issuer identified above has read this notice, knows the contents to be true, and has duly caused this notice to be signed on its behalf by the undersigned duly authorized person. |
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For signature, type in the signer's name or other letters or characters adopted or authorized as the signer's signature. |
| Issuer |
Signature |
Name of Signer |
Title |
Date |
| Cypress Equipment Fund 16, LLC |
/s/ DANIEL RAEL |
Daniel Rael |
Vice President of Manager of Issuer |
2009-08-03 |
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We believe in capital formation via the private placement. We believe that capital is the blood flow of the body-economic. Our goal is to assist people who participate in the capital formation process by bringing an anonymous form and social community to an undeserved market: the capital raiser. Join our community, help bring transparency and accountability to our business.
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