California Code of Regulations
Title 10 - Investment
Chapter 3 - Commissioner of Financial Protection and Innovation
Subchapter 2 - Corporate Securities
Article 5 - Conditions of Qualification
Subarticle 4 - Removal or Modification of Conditions
Section 260.141.50 - Application for Removal or Modification of Conditions
Current through Register 2024 Notice Reg. No. 38, September 20, 2024
An application for removal or modification of conditions on securities or on the qualification of securities imposed pursuant to Section 25141 or 25534 of the Code shall be made on the following form:
File No. _________________________
Insert file number of Issuer, if any
Fee: $ _________________________
See Corp. Code Sec. 25608(i) and (j)
Date of Application ____________________
DEPARTMENT OF BUSINESS OVERSIGHT STATE OF CALIFORNIA
APPLICATION FOR REMOVAL OF CONDITIONS
Imposed Pursuant to the Corporate Securities Law of 1968
___________________________
1. Name of Issuer: ___________________________
2. Address of Principal Office of Issuer: ___________________________
___________________________
3. Name and Address of Person to Whom Correspondence Regarding This Application Should be Addressed: ___________________________
___________________________
4. Identify each condition the removal of which is requested by this application.
5. State the justification for the requested removal of the condition.
6. If this is an application to remove conditions imposed upon promotional shares pursuant to Sections 260.141 and 260.141.1 of Title 10, California Code of Regulations, state the following information:
7. If this is an application for the removal of a restriction on transfer imposed by the Commissioner or for the removal of promotional conditions, state in tabular form the title and amount of securities called for by any options, warrants or rights, including the purchase price of the securities so called for and the expiration dates of such options, together with the market value of the securities so called for as of the latest practicable date. Such statement should include the foregoing information for all options held by each officer or director of the issuer.
8. If this is an application for the removal of an impound condition, furnish the information indicated by Section 260.141.24, Title 10, California Code of Regulations.
9. There are attached hereto as exhibits the following which are incorporated by reference:
10. The applicant has duly caused this application to be signed on its behalf by the undersigned, thereunto duly authorized.
______________________________
Applicant
By____________________________
______________________________
(Title)
I certify (or declare) under penalty of perjury under the laws of the State of California that I have read this application and the exhibits thereto and know the contents thereof, and that the statements therein are true and correct.
Executed at__________(Place) on __________(Date).
______________________________
(Signature)
Instruction:
The application may be made and signed either by the issuer or by the holders of the shares upon which the conditions are imposed.
1. New
Subarticle 4 (Section
260.141.50) filed 1-4-77;
effective thirtieth day thereafter (Register 77, No. 2).
2. Sections
refiled 1-7-77; effective thirtieth day thereafter (Register 77, No.
2).
3. Amendment filed 2-11-85; effective thirtieth day thereafter
(Register 85, No. 7).
4. Amendment of section and form filed
5-20-97; operative 5-20-97 pursuant to Government Code section
11343.4(d)
(Register 97, No. 21).
5. Change without regulatory effect amending
form filed 8-13-2014 pursuant to section
100, title 1, California Code of
Regulations (Register 2014, No. 33).
Note: Authority cited: Section 25610, Corporations Code. Reference: Section 25141, Corporations Code.
