The Securities and Exchange Commission has not necessarily reviewed the information in this filing and has not determined if it is accurate and complete. The reader should not assume that the information is accurate and complete. |
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM D
Notice of Exempt Offering of Securities
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| OMB APPROVAL |
| OMB Number: |
3235-0076 |
| Estimated average burden |
| hours per response: |
4.00 |
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1. Issuer's Identity
| CIK (Filer ID Number) |
Previous Names |
|
Entity Type |
| 0001673678 |
|
| |
Corporation |
| |
Limited Partnership |
| |
Limited Liability Company |
| |
General Partnership |
| |
Business Trust |
| X |
Other (Specify) |
Delaware Statutory Trust |
| Name of Issuer |
| Self-Storage Portfolio I DST |
| Jurisdiction of Incorporation/Organization |
| DELAWARE |
| Year of Incorporation/Organization |
| |
Over Five Years Ago |
| X |
Within Last Five Years (Specify Year) |
2016 |
| |
Yet to Be Formed |
|
2. Principal Place of Business and Contact Information
| Name of Issuer |
| Self-Storage Portfolio I DST |
| Street Address 1 |
Street Address 2 |
| 2901 BUTTERFIELD ROAD |
| City |
State/Province/Country |
ZIP/PostalCode |
Phone Number of Issuer |
| OAK BROOK |
ILLINOIS |
60523 |
630-218-8000 |
3. Related Persons
| Last Name |
First Name |
Middle Name |
| Inland Private |
Capital Corporation |
| Street Address 1 |
Street Address 2 |
| 2901 Butterfield Road |
| City |
State/Province/Country |
ZIP/PostalCode |
| Oak Brook |
ILLINOIS |
60523 |
| Relationship: |
|
Executive Officer |
|
Director |
X |
Promoter |
Clarification of Response (if Necessary):
Sponsor of the Issuer.
| Last Name |
First Name |
Middle Name |
| Self-Storage |
Portfolio I, L.L.C. |
| Street Address 1 |
Street Address 2 |
| 2901 Butterfield Road |
| City |
State/Province/Country |
ZIP/PostalCode |
| Oak Brook |
ILLINOIS |
60523 |
| Relationship: |
|
Executive Officer |
|
Director |
X |
Promoter |
Clarification of Response (if Necessary):
Depositor of the Issuer.
| Last Name |
First Name |
Middle Name |
| Self-Storage Portfolio I |
Exchange, L.L.C. |
| Street Address 1 |
Street Address 2 |
| 2901 Butterfield Road |
| City |
State/Province/Country |
ZIP/PostalCode |
| Oak Brook |
ILLINOIS |
60523 |
| Relationship: |
|
Executive Officer |
|
Director |
X |
Promoter |
Clarification of Response (if Necessary):
Signatory Trustee of the Issuer.
| Last Name |
First Name |
Middle Name |
| Lampi |
Keith |
| Street Address 1 |
Street Address 2 |
| 2901 Butterfield Road |
| City |
State/Province/Country |
ZIP/PostalCode |
| Oak Brook |
ILLINOIS |
60523 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
Mr. Lampi is the President of Inland Private Capital Corporation, the Member of Self-Storage Portfolio I Exchange, L.L.C., the Signatory Trustee of Self-Storage Portfolio I DST.
4. Industry Group
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Agriculture |
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Banking & Financial Services |
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| |
Commercial Banking |
| |
Insurance |
| |
Investing |
| |
Investment Banking |
| |
Pooled Investment Fund |
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Is the issuer registered as an investment company under the Investment Company Act of 1940? |
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| |
Other Banking & Financial Services |
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| |
Business Services |
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Energy |
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Health Care |
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| |
Manufacturing |
|
Real Estate |
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|
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Retailing |
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Restaurants |
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Technology |
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Travel |
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| |
Tourism & Travel Services |
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Other |
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5. Issuer Size
| Revenue Range |
OR |
Aggregate Net Asset Value Range |
| |
No Revenues |
|
No Aggregate Net Asset Value |
| |
$1 - $1,000,000 |
|
$1 - $5,000,000 |
| |
$1,000,001 - $5,000,000 |
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$5,000,001 - $25,000,000 |
| |
$5,000,001 - $25,000,000 |
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$25,000,001 - $50,000,000 |
| |
$25,000,001 - $100,000,000 |
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$50,000,001 - $100,000,000 |
| |
Over $100,000,000 |
|
Over $100,000,000 |
| X |
Decline to Disclose |
|
Decline to Disclose |
| |
Not Applicable |
|
Not Applicable |
6. Federal Exemption(s) and Exclusion(s) Claimed (select all that apply)
|
| |
Rule 504(b)(1) (not (i), (ii) or (iii)) |
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| |
Rule 504 (b)(1)(i) |
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| |
Rule 504 (b)(1)(ii) |
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| |
Rule 504 (b)(1)(iii) |
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| |
Rule 505 |
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| X |
Rule 506(b) |
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| |
Rule 506(c) |
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| |
Securities Act Section 4(a)(5) |
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| |
Investment Company Act Section 3(c) |
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| |
Section 3(c)(1) |
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Section 3(c)(9) |
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| |
Section 3(c)(2) |
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Section 3(c)(10) |
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| |
Section 3(c)(3) |
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Section 3(c)(11) |
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| |
Section 3(c)(4) |
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Section 3(c)(12) |
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| |
Section 3(c)(5) |
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Section 3(c)(13) |
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| |
Section 3(c)(6) |
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Section 3(c)(14) |
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7. Type of Filing
| |
New Notice |
|
Date of First Sale |
2016-04-22 |
|
|
First Sale Yet to Occur |
| X |
Amendment |
8. Duration of Offering
| Does the Issuer intend this offering to last more than one year? |
|
|
9. Type(s) of Securities Offered (select all that apply)
| |
Equity |
|
Pooled Investment Fund Interests |
| |
Debt |
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Tenant-in-Common Securities |
| |
Option, Warrant or Other Right to Acquire Another Security |
|
Mineral Property Securities |
| |
Security to be Acquired Upon Exercise of Option, Warrant or Other Right to Acquire Security |
X |
Other (describe) |
|
Beneficial interests in Delaware Statutory Trust reflecting beneficial interests in real estate. |
10. Business Combination Transaction
| Is this offering being made in connection with a business combination transaction, such as a merger, acquisition or exchange offer? |
|
|
Clarification of Response (if Necessary):
11. Minimum Investment
| Minimum investment accepted from any outside investor |
$25,000
|
USD |
12. Sales Compensation
| Recipient |
| Recipient CRD Number |
|
None |
|
| Inland Securites Corporation |
15807 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Inland Securites Corporation |
15807 |
| Street Address 1 |
Street Address 2 |
| 2901 Butterfield Road |
| City |
State/Province/Country |
ZIP/Postal Code |
| Oak Brook |
ILLINOIS |
60523 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Silver Portal Capital, LLC |
114290 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Silver Portal Capital, LLC |
114290 |
| Street Address 1 |
Street Address 2 |
| 12265 EL Camino Real, Suite 230 |
| City |
State/Province/Country |
ZIP/Postal Code |
| San Diego |
CALIFORNIA |
92130 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Preston P. Mokris |
5179201 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Concorde Investment Services, LLC |
151604 |
| Street Address 1 |
Street Address 2 |
| 633 Georgetown Road |
| City |
State/Province/Country |
ZIP/Postal Code |
| Raleigh |
NORTH CAROLINA |
27608 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Robert S. Smith |
1412333 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Concorde Investment Services, LLC |
151604 |
| Street Address 1 |
Street Address 2 |
| 5000 Meadows Road, Suite 230 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Lake Oswego |
OREGON |
97035 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
| CALIFORNIA |
| NEVADA |
| OREGON |
| WASHINGTON |
|
| Recipient |
| Recipient CRD Number |
|
None |
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| Steve J. Markey |
2591317 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Investacorp, Inc. |
7684 |
| Street Address 1 |
Street Address 2 |
| 559 E. Huisache Ave |
| City |
State/Province/Country |
ZIP/Postal Code |
| San Antonio |
TEXAS |
78212 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Patrick J. Lynch IV |
4603507 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Investocorp, Inc. |
7684 |
| Street Address 1 |
Street Address 2 |
| 559 E. Huisache Ave |
| City |
State/Province/Country |
ZIP/Postal Code |
| San Antonio |
TEXAS |
78212 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
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| Christina S. Nielson |
4866971 |
| (Associated) Broker or Dealer |
|
None |
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| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Primex |
29394 |
| Street Address 1 |
Street Address 2 |
| 650 Town Center Drive, Suite 1400 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Costa Mesa |
CALIFORNIA |
92626 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
| CALIFORNIA |
| FLORIDA |
| NEVADA |
|
| Recipient |
| Recipient CRD Number |
|
None |
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| Kyle H. Imhotle |
5448950 |
| (Associated) Broker or Dealer |
|
None |
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| (Associated) Broker or Dealer CRD Number |
|
None |
|
| 1st Global Capital Corp. |
30349 |
| Street Address 1 |
Street Address 2 |
| 1215 Washington Avenue S |
| City |
State/Province/Country |
ZIP/Postal Code |
| Detroit Lakes |
MINNESOTA |
56502 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
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| NORTH DAKOTA |
| SOUTH DAKOTA |
|
| Recipient |
| Recipient CRD Number |
|
None |
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| Troy Thomas |
4691720 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
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| McDermott Investment Services, LLC |
154926 |
| Street Address 1 |
Street Address 2 |
| 101 Main Street, Suite 260 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Huntington Beach |
CALIFORNIA |
92648 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Robert S. Paul |
1883555 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| 1st Global Capital Corp. |
30349 |
| Street Address 1 |
Street Address 2 |
| 1442 Irvine Blvd., Suite 234 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Tustin |
CALIFORNIA |
92780 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Jennifer A. Wildman |
4973672 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| 1st Global Capital Corp. |
30349 |
| Street Address 1 |
Street Address 2 |
| 915 N. Jefferson Avenue |
| City |
State/Province/Country |
ZIP/Postal Code |
| MT Pleasant |
TEXAS |
75455 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Joseph G. Michaletz |
1327534 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Concorde Investment Services, LLC |
151604 |
| Street Address 1 |
Street Address 2 |
| 150 St. Andrews Ct., Suite 210 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Mankato |
MINNESOTA |
56001 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
| COLORADO |
| GEORGIA |
| IOWA |
| MINNESOTA |
| NEBRASKA |
| TEXAS |
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| James T. Walesa |
1061209 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Triad Advisors, Inc. |
25803 |
| Street Address 1 |
Street Address 2 |
| 1460 Renaissance Dr., Suite 212 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Park Ridge |
ILLINOIS |
60068 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Robert L. Boggess |
5007422 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Sandlapper Sercurites, LLC |
137906 |
| Street Address 1 |
Street Address 2 |
| 2312 Eastlake Ave E |
| City |
State/Province/Country |
ZIP/Postal Code |
| Seattle |
WASHINGTON |
98103 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| John Goff |
1919761 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Investcorp, Inc. |
7684 |
| Street Address 1 |
Street Address 2 |
| 770 North Cotner Blvd, Suite 401 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Lincoln |
NEBRASKA |
68505 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Dennis I. Weiss |
462338 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| American Investors Company |
38 |
| Street Address 1 |
Street Address 2 |
| 8569 Cordes Circle, Suite 1 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Germantown |
TENNESSEE |
38139 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
| FLORIDA |
| TENNESSEE |
| WASHINGTON |
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Carol S. Grasso |
1635604 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Moloney Sercurties Co., Inc. |
38535 |
| Street Address 1 |
Street Address 2 |
| 501 St. Vrain Lane, Suite 100 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Estes Park |
COLORADO |
80517 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Gary E. Conley |
52159 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| American Investors Company |
38 |
| Street Address 1 |
Street Address 2 |
| 1600 Valley River Drive, Suite 385 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Eugene |
OREGON |
97401 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Timothy E. Tehan |
3230535 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Triad Advisors, Inc. |
25803 |
| Street Address 1 |
Street Address 2 |
| 7735 Old Georgetown Rd., Suite 800 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Bethesda |
MARYLAND |
20814 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Jeanne E. Morelli |
4706430 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| 1st Global Capital Corp. |
30349 |
| Street Address 1 |
Street Address 2 |
| 1000 First Federal Plaza |
| City |
State/Province/Country |
ZIP/Postal Code |
| Rochester |
NEW YORK |
14614 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Stephen J. Sanders |
2802569 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Cambridge Investment Research, Inc. |
39543 |
| Street Address 1 |
Street Address 2 |
| 1509 Mart Drive, Suite B |
| City |
State/Province/Country |
ZIP/Postal Code |
| Little Rock |
ARIZONA |
72202 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Nathaniel M. Kuhn |
4624143 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Concorde Investments Services, LLC |
151604 |
| Street Address 1 |
Street Address 2 |
| 120 W. Easstman, Suite 300 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Arlington Heights |
ILLINOIS |
60004 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Eric S. Scaff |
5281210 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Concorde Investments Services, LLC |
151604 |
| Street Address 1 |
Street Address 2 |
| 300 Montomery Street, Suite 631 |
| City |
State/Province/Country |
ZIP/Postal Code |
| San Francisco |
COLORADO |
94101 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Roger W. Bowlin |
1905652 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Concorde Investments Services, LLC |
151604 |
| Street Address 1 |
Street Address 2 |
| 507 SE Andrews Street |
| City |
State/Province/Country |
ZIP/Postal Code |
| Issaquah |
WASHINGTON |
98027 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| John W. Kenny |
268043 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| American Investors Company |
38 |
| Street Address 1 |
Street Address 2 |
| 24121 Wine Country Court |
| City |
State/Province/Country |
ZIP/Postal Code |
| Sonoma |
CALIFORNIA |
95746 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Michael A. Bendix |
5379777 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Cedar Crest Advisors, LLC |
187514 |
| Street Address 1 |
Street Address 2 |
| 406 W S Jordan Pkwy #200 |
| City |
State/Province/Country |
ZIP/Postal Code |
| South Jordan |
UTAH |
84095 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Molly M. Grubb |
5647291 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Cambridge Investment Research, Inc. |
39543 |
| Street Address 1 |
Street Address 2 |
| 454 E. Main Street, Suite 215 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Columbus |
OHIO |
43215 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Patrick T. Shea |
1654953 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Whitehall-Parker Securites, Inc. |
10608 |
| Street Address 1 |
Street Address 2 |
| 250 Bel Marin Keys Blvd., Suite F3 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Novato |
CALIFORNIA |
94949 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Richard A. Rupp |
2459269 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| First Financial Equity Corporation |
16507 |
| Street Address 1 |
Street Address 2 |
| 5230 Carroll Canyon Road, Suite 214 |
| City |
State/Province/Country |
ZIP/Postal Code |
| San Diego |
CALIFORNIA |
92121 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Bryon E. Martinsen |
1621649 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Centaurus Financial, Inc. |
30833 |
| Street Address 1 |
Street Address 2 |
| 220 Fort Salonga Road, Suite #301C |
| City |
State/Province/Country |
ZIP/Postal Code |
| Northport |
NEW YORK |
11768 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Thomas D. Sanders |
1280319 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Cambridge Investment Research, Inc. |
39543 |
| Street Address 1 |
Street Address 2 |
| 1509-B Mart Drive |
| City |
State/Province/Country |
ZIP/Postal Code |
| Little Rock |
ARKANSAS |
72202 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Bryan A. Decker |
5527656 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| 1st Global Capital Corp. |
30349 |
| Street Address 1 |
Street Address 2 |
| 5635 NE Elam Young Parkway, Suite 100 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Hillsboro |
OREGON |
97124 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Brett F. Ewing |
2904608 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Centaurus Financial, Inc. |
30833 |
| Street Address 1 |
Street Address 2 |
| 2528 Barrington Circle, Suite #1 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Tallahassee |
FLORIDA |
32308 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| William H. Lowell |
1158722 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Lowell & Company, Inc. |
24913 |
| Street Address 1 |
Street Address 2 |
| 4021 84th St, Suite 100 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Lubbock |
TEXAS |
79423 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Lamar D. Law III |
5952938 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| 1st Global Capital Corp. |
30349 |
| Street Address 1 |
Street Address 2 |
| 1134 Kennebec Drive |
| City |
State/Province/Country |
ZIP/Postal Code |
| Chamberburg |
PENNSYLVANIA |
17201 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| James J. Schipper |
2636447 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Triad Advisors, Inc. |
25803 |
| Street Address 1 |
Street Address 2 |
| 125 Ottawa Avenue, Suite 357 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Grand Rapids |
MICHIGAN |
49503 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Steven M. Osterink Sr. |
1019935 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Triad Advisors, Inc. |
25803 |
| Street Address 1 |
Street Address 2 |
| 125 Ottawa Avenue, Suite 357 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Grand Rapids |
MICHIGAN |
49503 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Clemont L. Bevill |
1790971 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Silver Oak Sercurities, Incorporated |
46947 |
| Street Address 1 |
Street Address 2 |
| 301 Oak Street, Suite 2-24 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Quincy |
ILLINOIS |
62301 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Carl F. Worden III |
3130121 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Centaurus Financial, Inc. |
30833 |
| Street Address 1 |
Street Address 2 |
| 3031 Tish Way, Suite #901 |
| City |
State/Province/Country |
ZIP/Postal Code |
| San Jose |
CALIFORNIA |
95128 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Robert A. Horning |
2311640 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Centaurus Financial, Inc. |
30833 |
| Street Address 1 |
Street Address 2 |
| 6633 S. Halm Avenue |
| City |
State/Province/Country |
ZIP/Postal Code |
| Los Angeles |
CALIFORNIA |
90056 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| James K. Johnston |
1689783 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Arete Wealth Management, LLC |
44856 |
| Street Address 1 |
Street Address 2 |
| 775 Ridge Lake Blvd., Suite 150 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Memphis |
TENNESSEE |
38120 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| David J. Segarra |
4482059 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Centraurus Financial, Inc. |
30833 |
| Street Address 1 |
Street Address 2 |
| 2777 Paradise Road, Suite #2002 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Las Vegas |
NEVADA |
89109 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Andrew P. Wittich |
4913069 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Cambridge Investment Research, Inc. |
39543 |
| Street Address 1 |
Street Address 2 |
| 920 Poeyfarre #427 |
| City |
State/Province/Country |
ZIP/Postal Code |
| New Orleans |
LOUISIANA |
70130 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Gordon T. Hamilton |
5028789 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Parkland Securities, LLC |
115368 |
| Street Address 1 |
Street Address 2 |
| 5875 Leham Drive, Suite 201E |
| City |
State/Province/Country |
ZIP/Postal Code |
| Colorado Springs |
COLORADO |
80918 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Timothy L. Stauffer |
4178198 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Concorde Investment Services, LLC |
151604 |
| Street Address 1 |
Street Address 2 |
| 333 Fiddlers Cove |
| City |
State/Province/Country |
ZIP/Postal Code |
| Fort Wayne |
INDIANA |
46825 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| John G. Montemarano |
1089597 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Sigma Financial Corporation |
14303 |
| Street Address 1 |
Street Address 2 |
| 3490 East Lake Road, Suite B |
| City |
State/Province/Country |
ZIP/Postal Code |
| Palm Harbor |
FLORIDA |
34685 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Douglas A. Henrickson |
869607 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Triad Advisors, Inc. |
25803 |
| Street Address 1 |
Street Address 2 |
| 6290 Jupiter Avenue, Suite B |
| City |
State/Province/Country |
ZIP/Postal Code |
| Belmont |
MICHIGAN |
49306 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Thomas M. Hess |
4957892 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| DFPG Investments, Inc. |
155576 |
| Street Address 1 |
Street Address 2 |
| 2104 Vista Laredo |
| City |
State/Province/Country |
ZIP/Postal Code |
| Newport Beach |
CALIFORNIA |
92660 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Jonathan R. Creighton |
1495897 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Concorde Investment Servics, LLC |
151604 |
| Street Address 1 |
Street Address 2 |
| 350 Lincoln Street, Suite 2400 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Hingham |
MASSACHUSETTS |
02043 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
| CONNECTICUT |
| MASSACHUSETTS |
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Lawrence R. Greenfield |
4056913 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Arete Wealth Management, LLC |
44856 |
| Street Address 1 |
Street Address 2 |
| 20750 Ventura Blvd., Suite 202 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Woodland Hills |
CALIFORNIA |
91634 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Carl Edwards Jr. |
550414 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Calton & Associates, Inc. |
20999 |
| Street Address 1 |
Street Address 2 |
| 6404 Carmel Rd., Suite 201 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Charlotte |
NORTH CAROLINA |
28266 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Blayne A. Andersen |
5727397 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Parkland Securities, LLC |
115368 |
| Street Address 1 |
Street Address 2 |
| 810 Pancheri Drive |
| City |
State/Province/Country |
ZIP/Postal Code |
| Idaho Falls |
IDAHO |
83402 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| James D. Kent Jr. |
2255753 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Newport Coast Securities, Inc. |
16944 |
| Street Address 1 |
Street Address 2 |
| 4551 Mainland Blvd. W., Suite D |
| City |
State/Province/Country |
ZIP/Postal Code |
| Pinellas Park |
FLORIDA |
33782 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| David A. Schlein |
4334470 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| 1st Global Capital Corp. |
30349 |
| Street Address 1 |
Street Address 2 |
| 369 Franklin Street, Cyclorama Building |
| City |
State/Province/Country |
ZIP/Postal Code |
| Buffalo |
NEW YORK |
14202 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Debra J. Schleining |
2768752 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| McDermott Investment Services, LLC |
154926 |
| Street Address 1 |
Street Address 2 |
| 13530 Parker Street |
| City |
State/Province/Country |
ZIP/Postal Code |
| Omaha |
NEBRASKA |
68154 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| John G. Chess |
4812430 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Investacorp, Inc. |
7684 |
| Street Address 1 |
Street Address 2 |
| 4263 Gavin Lane |
| City |
State/Province/Country |
ZIP/Postal Code |
| Columbus |
OHIO |
43220 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| John H. Scully |
803539 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Centaurus Financial, Inc. |
30833 |
| Street Address 1 |
Street Address 2 |
| 450 Skokie Blvd., Suite #301 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Northbrook |
ILLINOIS |
60062 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Kate M. King |
4654157 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Centaurus Financial, Inc. |
30833 |
| Street Address 1 |
Street Address 2 |
| 4000 Barranca Parkway, Suite #250 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Irvine |
CALIFORNIA |
92604 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Jerome O. Jacobs |
2160630 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| 1st Global Capital Corp. |
30349 |
| Street Address 1 |
Street Address 2 |
| 10500 Little Patuxent Parkway, Suite 710 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Columbia |
MARYLAND |
21044 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| William J. Bugdon |
5720121 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Investacorp, Inc. |
7684 |
| Street Address 1 |
Street Address 2 |
| Centaral Park East |
222 New Road, Suite 505 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Linwood |
NEW JERSEY |
08221 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Robert R. Tweed |
2339324 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Cabot Lodge Securities LLC |
159712 |
| Street Address 1 |
Street Address 2 |
| 2060 Huntington Drive, Suite 1 |
| City |
State/Province/Country |
ZIP/Postal Code |
| San Marino |
CALIFORNIA |
91108 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Patrick R. Conway |
1337831 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Investacorp, Inc. |
7684 |
| Street Address 1 |
Street Address 2 |
| 2901 Butterfield Rd. |
| City |
State/Province/Country |
ZIP/Postal Code |
| Oak Brook |
ILLINOIS |
60523 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Steven B. Shaiman |
4114227 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Calton & Associates, Inc. |
20999 |
| Street Address 1 |
Street Address 2 |
| 838 East Cherry Street, Suite One |
| City |
State/Province/Country |
ZIP/Postal Code |
| Vineland |
NEW JERSEY |
08360 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| John S. Weiss |
1097536 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Crown Capital Securities, L.P. |
6312 |
| Street Address 1 |
Street Address 2 |
| 29222 Rancho Viejo Rd., Suite 126-B |
| City |
State/Province/Country |
ZIP/Postal Code |
| San Juan Capistrano |
COLORADO |
92675 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Duane M. Toney |
4627140 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Cambridge Investment Research, Inc. |
39543 |
| Street Address 1 |
Street Address 2 |
| 6465 S 3000 E, Suite 200 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Salt Lake City |
UTAH |
84121 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Noah P. Bergeron Jr. |
1056146 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Sigma Financial Corporation |
14303 |
| Street Address 1 |
Street Address 2 |
| 35030 Michelle Drive |
| City |
State/Province/Country |
ZIP/Postal Code |
| Romulus |
MICHIGAN |
48174 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Thomas J. Ealy |
863042 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Investment Planners, Inc. |
18557 |
| Street Address 1 |
Street Address 2 |
| 2911 Crossing Court #102 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Champaign |
ILLINOIS |
61822 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| David G. Meachan |
1045678 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Centaurus Financial, Inc. |
30833 |
| Street Address 1 |
Street Address 2 |
| 16571 N. 109th Street |
| City |
State/Province/Country |
ZIP/Postal Code |
| Scottsdale |
ARIZONA |
85255 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Carl F. Worden III |
3130121 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Centaurus Financial, Inc. |
30833 |
| Street Address 1 |
Street Address 2 |
| 3031 Tisch Way, Suite #901 |
| City |
State/Province/Country |
ZIP/Postal Code |
| San Jose |
CALIFORNIA |
95128 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Carl A. Linquist |
4426314 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| JRL Capital Corporation |
10225 |
| Street Address 1 |
Street Address 2 |
| 20371 Irvine Ave, Suite A-140 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Newport Beach |
CALIFORNIA |
92660 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Timothy J. Kissling |
2515918 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| Madison Avenue Securities, LLC |
23224 |
| Street Address 1 |
Street Address 2 |
| 5117 Erie Street |
| City |
State/Province/Country |
ZIP/Postal Code |
| New Castle |
PENNSYLVANIA |
16102 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
13. Offering and Sales Amounts
| Total Offering Amount |
$49,364,432
|
USD |
|
| Total Amount Sold |
$41,080,976
|
USD |
| Total Remaining to be Sold |
$8,283,456
|
USD |
|
Clarification of Response (if Necessary):
14. Investors
|
Select if securities in the offering have been or may be sold to persons who do not qualify as accredited investors, and enter the number of such non-accredited investors who already have invested in the offering. |
|
|
Regardless of whether securities in the offering have been or may be sold to persons who do not qualify as accredited investors, enter the total number of investors who already have invested in the offering: |
|
15. Sales Commissions & Finder's Fees Expenses
Provide separately the amounts of sales commissions and finders fees expenses, if any. If the amount of an expenditure is not known, provide an estimate and check the box next to the amount.
| Sales Commissions |
$2,468,222
|
USD |
|
| Finders' Fees |
$0
|
USD |
|
Clarification of Response (if Necessary):
This response is based on the assumption that the full amount of the potential sales commissions will be earned and paid.16. Use of Proceeds
Provide the amount of the gross proceeds of the offering that has been or is proposed to be used for payments to any of the persons required to be named as executive officers, directors or promoters in response to Item 3 above. If the amount is unknown, provide an estimate and check the box next to the amount.
Clarification of Response (if Necessary):
Signature and Submission
Please verify the information you have entered and review the Terms of Submission below before signing and clicking SUBMIT below to file this notice.
Terms of Submission
| In submitting this notice, each issuer named above is: |
- Notifying the SEC and/or each State in which this notice is filed of the offering of
securities described and undertaking to furnish them, upon written request, in the accordance with applicable
law, the information furnished to offerees.*
- Irrevocably appointing each of the Secretary of the SEC and, the Securities Administrator
or other legally designated officer of the State in which the issuer maintains its principal
place of business and any State in which this notice is filed, as its agents for service of
process, and agreeing that these persons may accept service on its behalf, of any notice,
process or pleading, and further agreeing that such service may be made by registered or
certified mail, in any Federal or state action, administrative proceeding, or arbitration
brought against it in any place subject to the jurisdiction of the United States, if the
action, proceeding or arbitration (a) arises out of any activity in connection with the
offering of securities that is the subject of this notice, and (b) is founded, directly or
indirectly, upon the provisions of: (i) the Securities Act of 1933, the Securities Exchange
Act of 1934, the Trust Indenture Act of 1939, the Investment Company Act of 1940, or the
Investment Advisers Act of 1940, or any rule or regulation under any of these statutes, or (ii)
the laws of the State in which the issuer maintains its principal place of business or any State
in which this notice is filed.
- Certifying that, if the issuer is claiming a Regulation D exemption for the offering, the issuer is not disqualified from relying on Regulation D for one of the reasons stated in Rule 505(b)(2)(iii) or Rule 506(d).
|
Each Issuer identified above has read this notice, knows the contents to be true, and has duly caused this notice to be signed on its behalf by the undersigned duly authorized person.
For signature, type in the signer's name or other letters or characters adopted or authorized as the signer's signature.
| Issuer |
Signature |
Name of Signer |
Title |
Date |
| Self-Storage Portfolio I DST |
/s/ Keith Lampi |
Keith Lampi |
President of the Member of the Signatory Trustee |
2016-09-08 |
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.
* This undertaking does not affect any limits Section 102(a) of the National Securities Markets
Improvement Act of 1996 ("NSMIA") [Pub. L. No. 104-290, 110 Stat. 3416 (Oct. 11, 1996)] imposes on the ability of States to
require information. As a result, if the securities that are the subject of this Form D are "covered securities" for purposes
of NSMIA, whether in all instances or due to the nature of the offering that is the subject of this Form D, States cannot
routinely require offering materials under this undertaking or otherwise and can require offering materials only to the
extent NSMIA permits them to do so under NSMIA's preservation of their anti-fraud authority.