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.

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Lead State

Upon filing, the states indicated above and the Program Administrator State will select a Lead State and Lead Examiner to coordinate the review of the registration.

Program Administrator State

The State of Texas is acting as the Porgam Administrator State for Southwest Regional Review. The Program Administrator State will consult with states in which an application has been filed and will select a Lead State and Lead Examiner. Please file a copy of this form, along with the Disclosure Document, with the Program Administrator State, even if the issuer does not intend to register its shares for sale in the state of the Program Administrator.

Filing Fees

The issuer shall pay the normal filing fees for each state in which it files. There is no additional fee for regional review. Do not send fees to the Program Administrator State unless the issuer intends to register its securities in that state.

Filings and Amendments

The issuer shall file an identical application, including the Regional Review Form, the Form U-1, the Disclosure Document and the exhibits, contemporaneously in all of the Regional Review States in which it is registering. Subsequent amendments shall also be filed contemporaneously in these states and the Program Administrator State. When filing an amendment to the Disclosure Document, the issuer shall file an additional copy of the amendment marked by underlining to indicate clearly and precisely the changes made by the amendment.

Regional Review Comment Process

The issuer agrees to resolve all comments through the Lead State unless the Lead State directs the issuer to resolve the comment with the commenting state. The initial comment period for Regional Review will take approximately thirty (30) business days. The issuer understands that any application filed in an additional state after the initial filing will lengthen the time for review. Final clearance of a Regional Review filing requires that all comments be resolved and all registration standards be met. The issuer should also understand that the Regional Review States will be applying NASAA Statements of Policy for review of the registration. For information on these registration standards, please contact your home state or the Program Administrator State.

Adding Additional States After Clearance

After the Lead State has given notice of clearance, no assurance can be given that the addition of another state or jurisdiction to the offering will be accorded Regional Review. The issuer should give careful consideration at the time of its initial filing of the states in which it desires Regional Review.

Waiver of Automatic Effectiveness

The issuer waives automatic effectiveness in the states identified above.

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Authorized Representative for the Issuer

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Print Name

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Title

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Name of Issuer

Southwest Regional Review Protocol