SOUTHWEST REGIONAL REVIEW FORM
SMALL BUSINESS SECURITIES OFFERING
The issuer requests that this state registration filing be processed as a Regional Review filing.
Regional Review for small business securities offerings is available only to SCOR and Regulation A offerings. Please refer to the North American Securities Administrators Association SCOR Policy Statement, NASAA Rep. (CCH) ¶411 (April 28, 1996), for the qualifications for SCOR and to Securities and Exchange Commission Regulation A, 17 C.F.R. § 230.254.
Please attach this form to the front of the Form U-1 filed as the issuer's application for registration and state in the cover letter accompanying the application that the issuer requests Regional Review. Send a copy of this form and the cover letter to each state in which the issuer intends to register and to Texas as Program Administrator. Regional Review is only available if the issuer intends to register in two or more of the participating states in the table below.
Please indicate on the table beloew the Regional Review states in which the issuer intends to file for registration. These states should also be listed in item 7 of the Form U-1 in addition to all other states in which application for registration is being made.