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1. Give full name of corporation, partnership or association.

2. If partnership, has your firm name been properly filed of record?

3. If corporation, when were you incorporated?

4. Have you paid your last annual license fee to the state?

5. What is your capitalization?

6. In how many shares is the company divided?

7. Is the stock assessable or non-assessable?

8. Do you have common or preferred stock?

9. If you have common or preferred stock, how much common and how much preferred stock have you?

10. State the object of the company in issuing these two kinds of stock.

11. What advantage has the preferred over the common?

12. What is the preferred stock selling for? Also the common? How much have you sold to date of each?

13. What are the names of the present stockholders and their addresses and how much cash have they paid for the stock they hold?

14. If they have not paid cash—what did they give for their stock?

15. Has any stock or interest in the company been given for the promotion of the company? If so, how much or what interest?