Free 0FFICE OF THE SECRETARY OF STATE - Texas

OFFICE OF THE SECRETARY OF STATE Statutory Documents Section, P.O. Box 13550 Austin, Texas 78711-3550


BUSINESS OPPORTUNITY REGISTRATION
Filing Fee: $195.00

Name of Seller: Address: City:

_________________________________________________________________________________________

_______________________________________________________________________________________________

___________________________________________________________________ State:______ Zip:________________

Telephone Number(s): ______________________________________________________

EXHIBITS: ______1) A list of the name and resident address of each individual who sells or will sell the business opportunity for the seller. (Attach as Exhibit A). ______2) Disclosure Statement required by Subchapter D of the Business Opportunity Act, Tex. Bus. & Com. Code, § 51.001 et seq. including, but not limited to: (attach as Exhibit B) a) b) c) d) e) f) g) h) i) j) k) l) m) Cover sheet entitled "Disclosures Required by Texas Law" containing the disclosures required by § 51.152 of the Business Opportunity Act Seller's name(s), and former name(s), form of doing business, name(s) of partners or affiliates. Names, addresses, and titles of seller's officers, directors, trustees, partners, executives and stockholders with 20% or more ownership. Statement on length of time involved in current and prior Business Opportunity sale ventures. Service performance description. Seller's Financial Statement. Training description, if relevant. Statement on services or agreements with equipment placement, if relevant. 45 day Contract Cancellation Statement, if relevant. Sales Earning Statement, if relevant. Civil or Criminal Record Statement. Bankruptcy or Insolvency Statement. Copy of Business Opportunity Contract.

______3) (If required) Bond, Trust Account or Irrevocable Letter of Credit Notification (Attach as Exhibit C).

PLEASE NOTE ADDITIONAL SUPPLEMENTAL FILINGS: ______4) Salesperson updates required every 6 months. ______5) Disclosure statement, to be updated annually or whenever there is a change.

Filing Fee - $25.00 each

FORM #2701

Rev. 4/21/99