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. |
|
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM D
Notice of Exempt Offering of Securities
|
| OMB APPROVAL |
| OMB Number: |
3235-0076 |
| Estimated average burden |
| hours per response: |
4.00 |
|
|
1. Issuer's Identity
| CIK (Filer ID Number) |
Previous Names |
|
Entity Type |
| 0001758222 |
|
| |
Corporation |
| |
Limited Partnership |
| |
Limited Liability Company |
| |
General Partnership |
| X |
Business Trust |
| |
Other (Specify) |
|
| Name of Issuer |
| Arizona Healthcare II DST |
| Jurisdiction of Incorporation/Organization |
| DELAWARE |
| Year of Incorporation/Organization |
| |
Over Five Years Ago |
| X |
Within Last Five Years (Specify Year) |
2018 |
| |
Yet to Be Formed |
|
2. Principal Place of Business and Contact Information
| Name of Issuer |
| Arizona Healthcare II DST |
| Street Address 1 |
Street Address 2 |
| 2901 BUTTERFIELD ROAD |
| City |
State/Province/Country |
ZIP/PostalCode |
Phone Number of Issuer |
| OAK BROOK |
ILLINOIS |
60523 |
8886711031 |
3. Related Persons
| Last Name |
First Name |
Middle Name |
| Arizona Healthcare II, L.L.C. |
N/A |
| 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 |
| Arizona Healthcare II Exchange, L.L.C. |
N/A |
| 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):
President and COO of the Sole Member of the Signatory Trustee of the Issuer
4. Industry Group
| |
Agriculture |
|
Banking & Financial Services |
|
| |
Commercial Banking |
| |
Insurance |
| |
Investing |
| |
Investment Banking |
| |
Pooled Investment Fund |
|
|
|
Is the issuer registered as an investment company under the Investment Company Act of 1940? |
|
|
| |
Other Banking & Financial Services |
|
| |
Business Services |
|
Energy |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Health Care |
|
|
|
|
|
|
|
|
|
|
| |
Manufacturing |
|
Real Estate |
|
|
|
|
|
|
|
|
|
|
|
|
Retailing |
|
Restaurants |
|
Technology |
|
|
|
|
|
|
|
Travel |
|
|
|
|
|
| |
Tourism & Travel Services |
|
|
|
|
Other |
|
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 |
|
$5,000,001 - $25,000,000 |
| |
$5,000,001 - $25,000,000 |
|
$25,000,001 - $50,000,000 |
| |
$25,000,001 - $100,000,000 |
|
$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)) |
|
| |
Rule 504 (b)(1)(i) |
|
| |
Rule 504 (b)(1)(ii) |
|
| |
Rule 504 (b)(1)(iii) |
|
| X |
Rule 506(b) |
|
| |
Rule 506(c) |
|
| |
Securities Act Section 4(a)(5) |
|
| |
Investment Company Act Section 3(c) |
|
| |
Section 3(c)(1) |
|
Section 3(c)(9) |
|
| |
Section 3(c)(2) |
|
Section 3(c)(10) |
|
| |
Section 3(c)(3) |
|
Section 3(c)(11) |
|
| |
Section 3(c)(4) |
|
Section 3(c)(12) |
|
| |
Section 3(c)(5) |
|
Section 3(c)(13) |
|
| |
Section 3(c)(6) |
|
Section 3(c)(14) |
|
|
|
7. Type of Filing
| |
New Notice |
|
Date of First Sale |
2018-10-31 |
|
|
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 |
|
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 |
|
| 1ST GLOBAL CAPITAL CORP. |
30349 |
| (Associated) Broker or Dealer |
X |
None |
|
| (Associated) Broker or Dealer CRD Number |
X |
None |
|
| None |
None |
| Street Address 1 |
Street Address 2 |
| 12750 MERIT DRIVE |
| City |
State/Province/Country |
ZIP/Postal Code |
| Dallas |
TEXAS |
75251 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
X |
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| CAMBRIDGE INVESTMENT RESEARCH, INC. |
39543 |
| (Associated) Broker or Dealer |
X |
None |
|
| (Associated) Broker or Dealer CRD Number |
X |
None |
|
| None |
None |
| Street Address 1 |
Street Address 2 |
| 1776 PLEASANT PLAIN RD. |
| City |
State/Province/Country |
ZIP/Postal Code |
| FAIRFIELD |
IOWA |
52556 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
X |
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| LINCOLN FINANCIAL ADVISORS CORPORATION |
3978 |
| (Associated) Broker or Dealer |
X |
None |
|
| (Associated) Broker or Dealer CRD Number |
X |
None |
|
| None |
None |
| Street Address 1 |
Street Address 2 |
| 1300 SOUTH CLINTON STREET |
| City |
State/Province/Country |
ZIP/Postal Code |
| FORT WAYNE |
INDIANA |
46802 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
X |
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| RCX CAPITAL GROUP, LLC |
114290 |
| (Associated) Broker or Dealer |
X |
None |
|
| (Associated) Broker or Dealer CRD Number |
X |
None |
|
| None |
None |
| Street Address 1 |
Street Address 2 |
| 2002 TIMBERLOCH PLACE |
| City |
State/Province/Country |
ZIP/Postal Code |
| THE WOODLANDS |
TEXAS |
77380 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
X |
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| WEALTHFORGE SECURITIES, LLC |
152550 |
| (Associated) Broker or Dealer |
X |
None |
|
| (Associated) Broker or Dealer CRD Number |
X |
None |
|
| None |
None |
| Street Address 1 |
Street Address 2 |
| 109 E 10th Street Suite 300 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Austin |
TEXAS |
78701 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
X |
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| CONCORDE INVESTMENT SERVICES, LLC |
151604 |
| (Associated) Broker or Dealer |
X |
None |
|
| (Associated) Broker or Dealer CRD Number |
X |
None |
|
| None |
None |
| 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 |
X |
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| CURTIS JEROME SATHRE III |
2459115 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| JRL CAPITAL CORPORATION |
10225 |
| Street Address 1 |
Street Address 2 |
| 23121 VERDUGO DR STE 205 |
| City |
State/Province/Country |
ZIP/Postal Code |
| LAGUNA HILLS |
CALIFORNIA |
92653 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| STEPHEN ROBERT NORTON |
2132723 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| MONEY CONCEPTS CAPITAL CORP |
12963 |
| Street Address 1 |
Street Address 2 |
| 8800 SE Sunnyside Road ste. 107n |
| City |
State/Province/Country |
ZIP/Postal Code |
| Clackamas |
OREGON |
97015 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| HUGO GRIMALDI |
4626118 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| MONEY CONCEPTS CAPITAL CORP |
12963 |
| Street Address 1 |
Street Address 2 |
| 8800 SE Sunnyside Road ste. 107n |
| City |
State/Province/Country |
ZIP/Postal Code |
| Clackamas |
OREGON |
97015 |
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 |
|
|
| ARKANSAS |
| CALIFORNIA |
| COLORADO |
| FLORIDA |
| LOUISIANA |
| MISSISSIPPI |
| NEW YORK |
| NORTH CAROLINA |
| OREGON |
| TENNESSEE |
| VIRGINIA |
| WASHINGTON |
| WISCONSIN |
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| INDEPENDENT FINANCIAL GROUP, LLC |
7717 |
| (Associated) Broker or Dealer |
X |
None |
|
| (Associated) Broker or Dealer CRD Number |
X |
None |
|
| None |
None |
| Street Address 1 |
Street Address 2 |
| 2075 TRESTLE GLEN RD. |
| City |
State/Province/Country |
ZIP/Postal Code |
| WALNUT CREEK |
CALIFORNIA |
94598 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
X |
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| MCDERMOTT INVESTMENT SERVICES, LLC |
154926 |
| (Associated) Broker or Dealer |
X |
None |
|
| (Associated) Broker or Dealer CRD Number |
X |
None |
|
| None |
None |
| Street Address 1 |
Street Address 2 |
| 6633 S. Halm Ave. |
| 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 |
X |
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| CHRISTINA SUZANNE NIELSON |
4866971 |
| (Associated) Broker or Dealer |
|
None |
|
| (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 |
|
|
| ALABAMA |
| ALASKA |
| ARIZONA |
| ARKANSAS |
| CALIFORNIA |
| COLORADO |
| CONNECTICUT |
| FLORIDA |
| GEORGIA |
| HAWAII |
| IDAHO |
| ILLINOIS |
| INDIANA |
| IOWA |
| LOUISIANA |
| MAINE |
| MARYLAND |
| MASSACHUSETTS |
| MICHIGAN |
| MINNESOTA |
| MISSOURI |
| NEVADA |
| NEW JERSEY |
| NEW MEXICO |
| NEW YORK |
| NORTH CAROLINA |
| NORTH DAKOTA |
| OHIO |
| OKLAHOMA |
| OREGON |
| PENNSYLVANIA |
| RHODE ISLAND |
| SOUTH CAROLINA |
| SOUTH DAKOTA |
| TENNESSEE |
| TEXAS |
| UTAH |
| VIRGINIA |
| WASHINGTON |
| WISCONSIN |
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| NORMAN WILLIAM VERTREES |
454413 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| ROYAL ALLIANCE ASSOCIATES, INC. |
23131 |
| Street Address 1 |
Street Address 2 |
| 1260 "B" STREET SUITE 375 |
| City |
State/Province/Country |
ZIP/Postal Code |
| HAYWARD |
CALIFORNIA |
94541 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
| ARIZONA |
| ARKANSAS |
| CALIFORNIA |
| COLORADO |
| FLORIDA |
| GEORGIA |
| HAWAII |
| IDAHO |
| INDIANA |
| KENTUCKY |
| MARYLAND |
| MASSACHUSETTS |
| MONTANA |
| NEVADA |
| NEW JERSEY |
| NEW MEXICO |
| NEW YORK |
| OHIO |
| OREGON |
| PENNSYLVANIA |
| TEXAS |
| VIRGINIA |
| WASHINGTON |
| WISCONSIN |
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| MONROE M DIEFENDORF JR |
805205 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| VANDERBILT SECURITIES, LLC |
5953 |
| Street Address 1 |
Street Address 2 |
| 152 Forest Avenue |
| City |
State/Province/Country |
ZIP/Postal Code |
| Locust Valley |
NEW YORK |
11560 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| MICHAEL PATRICK CROSS |
3025772 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| WOODBURY FINANCIAL SERVICES, INC. |
421 |
| Street Address 1 |
Street Address 2 |
| 2999 N 44TH STREET #120 |
| City |
State/Province/Country |
ZIP/Postal Code |
| PHOENIX |
ARIZONA |
85018 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
| ARIZONA |
| CALIFORNIA |
| COLORADO |
| ILLINOIS |
| KENTUCKY |
| WASHINGTON |
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| RYAN DAVID FINCH |
6379871 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| COLORADO FINANCIAL SERVICE CORPORATION |
104343 |
| Street Address 1 |
Street Address 2 |
| 7600 E Eastman Ave Suite 410 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Denver |
COLORADO |
80231 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| MICHAEL DONOVAN PULS |
2671882 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| WOODBURY FINANCIAL SERVICES, INC. |
421 |
| Street Address 1 |
Street Address 2 |
| 7431 O STREET |
| City |
State/Province/Country |
ZIP/Postal Code |
| LINCOLN |
NEBRASKA |
68510 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
| ARIZONA |
| CALIFORNIA |
| COLORADO |
| CONNECTICUT |
| FLORIDA |
| IDAHO |
| ILLINOIS |
| INDIANA |
| IOWA |
| KANSAS |
| MAINE |
| MINNESOTA |
| MISSISSIPPI |
| MISSOURI |
| MONTANA |
| NEBRASKA |
| NEW MEXICO |
| NEW YORK |
| OHIO |
| OKLAHOMA |
| OREGON |
| PENNSYLVANIA |
| SOUTH CAROLINA |
| SOUTH DAKOTA |
| TEXAS |
| WASHINGTON |
| WISCONSIN |
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| EDWARD ERIC FERNANDEZ |
2956661 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| CAPULENT LLC |
155155 |
| Street Address 1 |
Street Address 2 |
| 1 Spectrum Pointe Drive Ste 320 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Lake Forest |
CALIFORNIA |
92630 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
| ALABAMA |
| ALASKA |
| ARIZONA |
| CALIFORNIA |
| CONNECTICUT |
| FLORIDA |
| GEORGIA |
| ILLINOIS |
| IOWA |
| LOUISIANA |
| NEW JERSEY |
| NEW MEXICO |
| NEW YORK |
| NORTH CAROLINA |
| OHIO |
| OREGON |
| TENNESSEE |
| TEXAS |
| UTAH |
| VIRGINIA |
| WASHINGTON |
| WISCONSIN |
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| JOHN PATRICK OCHSNER |
1502183 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| CETERA ADVISORS LLC |
10299 |
| Street Address 1 |
Street Address 2 |
| 3217 W SMITH ST STE 3 |
| City |
State/Province/Country |
ZIP/Postal Code |
| SEATTLE |
WASHINGTON |
98199 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
| ALASKA |
| CALIFORNIA |
| FLORIDA |
| GEORGIA |
| NEW YORK |
| OREGON |
| WASHINGTON |
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| NATHANIEL EDWARD EDIE |
4278231 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| CETERA ADVISORS LLC |
10299 |
| Street Address 1 |
Street Address 2 |
| 15808 WEST DODGE RD STE 200 |
| City |
State/Province/Country |
ZIP/Postal Code |
| OMAHA |
NEBRASKA |
68118 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
| ARIZONA |
| ARKANSAS |
| CALIFORNIA |
| COLORADO |
| FLORIDA |
| GEORGIA |
| ILLINOIS |
| IOWA |
| KANSAS |
| LOUISIANA |
| MICHIGAN |
| MINNESOTA |
| MISSOURI |
| MONTANA |
| NEBRASKA |
| NEVADA |
| OHIO |
| OKLAHOMA |
| TEXAS |
| VIRGINIA |
| WASHINGTON |
| WISCONSIN |
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Gregory Hill |
850818 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| COLORADO FINANCIAL SERVICE CORPORATION |
104343 |
| Street Address 1 |
Street Address 2 |
| 304 INVERNESS WAY SOUTH SUITE 355 |
| City |
State/Province/Country |
ZIP/Postal Code |
| CENTENNIAL |
COLORADO |
80112 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| TIMOTHY KIRKPATRICK WHIPPLE |
2829688 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| DFPG INVESTMENTS, INC. |
155576 |
| Street Address 1 |
Street Address 2 |
| 742 N 530 E |
| City |
State/Province/Country |
ZIP/Postal Code |
| OREM |
UTAH |
84097 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
| ARIZONA |
| CALIFORNIA |
| COLORADO |
| CONNECTICUT |
| IDAHO |
| ILLINOIS |
| MICHIGAN |
| MISSOURI |
| NEVADA |
| NEW JERSEY |
| NEW YORK |
| OHIO |
| UTAH |
| WASHINGTON |
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| ALEXANDER JOSEPH HAVILAND |
6364128 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| DFPG INVESTMENTS, INC. |
155576 |
| Street Address 1 |
Street Address 2 |
| 742 N 530 E |
| City |
State/Province/Country |
ZIP/Postal Code |
| OREM |
UTAH |
84097 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| MICHAEL DAVID FRANKLIN |
5390262 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| DFPG INVESTMENTS, INC. |
155576 |
| Street Address 1 |
Street Address 2 |
| 903 SPRINGWOOD LANE |
| City |
State/Province/Country |
ZIP/Postal Code |
| ENCINITAS |
CALIFORNIA |
92024 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
| CALIFORNIA |
| TEXAS |
| WASHINGTON |
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| ROBIN TOM NAYLOR |
1392433 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| EMERSON EQUITY LLC |
130032 |
| Street Address 1 |
Street Address 2 |
| 18331 SE 280th Street |
| City |
State/Province/Country |
ZIP/Postal Code |
| Kent |
WASHINGTON |
98042 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
| ARIZONA |
| CALIFORNIA |
| UTAH |
| WASHINGTON |
| WYOMING |
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| ROGER M SMITH |
1964274 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| FIRST ALLIED SECURITIES, INC. |
32444 |
| Street Address 1 |
Street Address 2 |
| 383 Inverness Parkway #400 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Englewood |
COLORADO |
80112 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
| ARIZONA |
| CALIFORNIA |
| COLORADO |
| FLORIDA |
| GEORGIA |
| IDAHO |
| ILLINOIS |
| IOWA |
| MASSACHUSETTS |
| MICHIGAN |
| MISSOURI |
| NEBRASKA |
| NEVADA |
| NEW YORK |
| NORTH CAROLINA |
| OHIO |
| PENNSYLVANIA |
| SOUTH CAROLINA |
| TEXAS |
| UTAH |
| VIRGINIA |
| WASHINGTON |
| WISCONSIN |
| WYOMING |
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| LOIS ANN LEYNSE |
2949395 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| HD VEST INVESTMENT SERVICES |
13686 |
| Street Address 1 |
Street Address 2 |
| 295 27TH STREET |
| City |
State/Province/Country |
ZIP/Postal Code |
| OAKLAND |
CALIFORNIA |
94612 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
| ARIZONA |
| CALIFORNIA |
| COLORADO |
| FLORIDA |
| HAWAII |
| IOWA |
| MICHIGAN |
| NEVADA |
| NEW JERSEY |
| OREGON |
| PENNSYLVANIA |
| TEXAS |
| WASHINGTON |
| WISCONSIN |
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| KENDRA LEE ERKAMAA |
4856375 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| HARBOUR INVESTMENTS, INC. |
19258 |
| Street Address 1 |
Street Address 2 |
| 3101 INGERSOLL AVE SUITE 204 |
| City |
State/Province/Country |
ZIP/Postal Code |
| DES MOINES |
IOWA |
50312 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
| ARIZONA |
| CALIFORNIA |
| COLORADO |
| CONNECTICUT |
| FLORIDA |
| HAWAII |
| ILLINOIS |
| IOWA |
| KANSAS |
| KENTUCKY |
| MINNESOTA |
| MISSOURI |
| NEBRASKA |
| NEW JERSEY |
| NEW YORK |
| NORTH CAROLINA |
| NORTH DAKOTA |
| OREGON |
| TEXAS |
| WISCONSIN |
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| MARK ALLEN HERDING |
2239357 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| HARBOUR INVESTMENTS, INC. |
19258 |
| Street Address 1 |
Street Address 2 |
| 2198 E Camelback Rd. Ste 315 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Phoenix |
ARIZONA |
85016 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
| ARIZONA |
| CALIFORNIA |
| COLORADO |
| CONNECTICUT |
| FLORIDA |
| ILLINOIS |
| MISSOURI |
| NEVADA |
| NEW MEXICO |
| NORTH CAROLINA |
| SOUTH CAROLINA |
| WISCONSIN |
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| PAUL M GETTY |
6470002 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| LIGHTPATH CAPITAL, INC |
34617 |
| Street Address 1 |
Street Address 2 |
| 2025 Gateway Place, Ste. 485 |
| City |
State/Province/Country |
ZIP/Postal Code |
| San Jose |
CALIFORNIA |
95110 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
| CALIFORNIA |
| FLORIDA |
| NEVADA |
| NEW YORK |
| OREGON |
| WASHINGTON |
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Frank Piscitelli |
6935623 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| LIGHTPATH CAPITAL, INC |
34617 |
| Street Address 1 |
Street Address 2 |
| 160 Saratoga Ave., Unit. 110 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Santa Clara |
CALIFORNIA |
95051 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
| CALIFORNIA |
| NEW MEXICO |
| OREGON |
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| JEFFREY ALLEN MORRIS |
2478499 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| MOLONEY SECURITIES 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 |
|
| JULIENNE ELIZABETH RIDDELL |
5682274 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| SANDLAPPER SECURITIES, LLC |
137906 |
| Street Address 1 |
Street Address 2 |
| SANDLAPPER FINANCIAL CENTER 800 E. |
NORTH STREET, 2ND FLOOR |
| City |
State/Province/Country |
ZIP/Postal Code |
| GREENVILLE |
SOUTH CAROLINA |
29601 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
| FLORIDA |
| MICHIGAN |
| NEW YORK |
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| JAMES DALE WARRING |
3198200 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| TRIAD ADVISORS LLC |
25803 |
| Street Address 1 |
Street Address 2 |
| 1101 Wootton Parkway Suite 400 |
| City |
State/Province/Country |
ZIP/Postal Code |
| ROCKVILLE |
MARYLAND |
20852 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
| ARKANSAS |
| CALIFORNIA |
| DISTRICT OF COLUMBIA |
| FLORIDA |
| KENTUCKY |
| MARYLAND |
| MASSACHUSETTS |
| NEVADA |
| NEW HAMPSHIRE |
| NEW JERSEY |
| NEW YORK |
| NORTH CAROLINA |
| PENNSYLVANIA |
| SOUTH CAROLINA |
| VIRGINIA |
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| JEFFREY JOHN MCKAY |
818303 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| VOYA FINANCIAL ADVISORS, INC. |
2882 |
| Street Address 1 |
Street Address 2 |
| 6000 SOUTHCENTER BLVD STE 70 |
| City |
State/Province/Country |
ZIP/Postal Code |
| TUKWILA |
WASHINGTON |
98188 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
| ALABAMA |
| ALASKA |
| ARIZONA |
| ARKANSAS |
| CALIFORNIA |
| COLORADO |
| CONNECTICUT |
| DELAWARE |
| DISTRICT OF COLUMBIA |
| FLORIDA |
| GEORGIA |
| HAWAII |
| IDAHO |
| ILLINOIS |
| INDIANA |
| IOWA |
| KANSAS |
| KENTUCKY |
| LOUISIANA |
| MAINE |
| MARYLAND |
| MASSACHUSETTS |
| MICHIGAN |
| MINNESOTA |
| MISSISSIPPI |
| MISSOURI |
| MONTANA |
| NEBRASKA |
| NEVADA |
| NEW HAMPSHIRE |
| NEW JERSEY |
| NEW MEXICO |
| NEW YORK |
| NORTH CAROLINA |
| NORTH DAKOTA |
| OHIO |
| OKLAHOMA |
| OREGON |
| PENNSYLVANIA |
| RHODE ISLAND |
| SOUTH CAROLINA |
| SOUTH DAKOTA |
| TENNESSEE |
| TEXAS |
| UTAH |
| VIRGINIA |
| WASHINGTON |
| WISCONSIN |
| WYOMING |
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| STEVEN IRA KOLINSKY |
1090913 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| AMERICAN PORTFOLIOS FINANCIAL SERVICES, INC. |
18487 |
| Street Address 1 |
Street Address 2 |
| 500 North Franklin Turnpike Suite 104 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Ramsey |
NEW JERSEY |
07446 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| ADAM B WRIGHT |
6234854 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| CENTER STREET SECURITIES, INC. |
26898 |
| Street Address 1 |
Street Address 2 |
| 5416 E. Southern Ave Suite 107 |
| City |
State/Province/Country |
ZIP/Postal Code |
| MESA |
ARIZONA |
85206 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
| ARIZONA |
| CALIFORNIA |
| NEBRASKA |
| NEVADA |
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| DENNIS P OCONNOR |
1595467 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| CETERA ADVISORS LLC |
10299 |
| Street Address 1 |
Street Address 2 |
| 28 BLANCHARD DRIVE |
| 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 |
|
| JOHN EDWARD BISHOP |
866202 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| CHALICE CAPITAL PARTNERS, LLC |
288898 |
| Street Address 1 |
Street Address 2 |
| 440 Stevens Avenue Suite 200 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Solana Beach |
CALIFORNIA |
92075 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| MICHAEL ALLAN BENDIX |
5379777 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| DFPG INVESTMENTS, INC. |
155576 |
| Street Address 1 |
Street Address 2 |
| 903 SPRINGWOOD LANE |
| City |
State/Province/Country |
ZIP/Postal Code |
| ENCINITAS |
CALIFORNIA |
92024 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| WILLIAM SCOTT SHEEHAN |
2328614 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| DFPG INVESTMENTS, INC. |
155576 |
| Street Address 1 |
Street Address 2 |
| 2 ORR HATCH DRIVE |
| City |
State/Province/Country |
ZIP/Postal Code |
| CONRWALL |
NEW YORK |
12518 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| JOSEPH ERNEST HUBBARD |
2128362 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| FIRST FINANCIAL EQUITY CORPORATION |
16507 |
| Street Address 1 |
Street Address 2 |
| 5619 DTC PARKWAY, SUITE 1050 TERRACE TOW |
| City |
State/Province/Country |
ZIP/Postal Code |
| GREENWOOD VILLAGE |
COLORADO |
80111 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| MICHAEL JOSEPH STERLING |
2237482 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| FSC SECURITIES CORPORATION |
7461 |
| Street Address 1 |
Street Address 2 |
| 3356 SIX FORKS ROAD |
| City |
State/Province/Country |
ZIP/Postal Code |
| RALEIGH |
NORTH CAROLINA |
27609 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| DAVIN J CAREY |
5413012 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| HD VEST INVESTMENT SERVICES |
13686 |
| Street Address 1 |
Street Address 2 |
| 1000 Town Center Drive Suite 200 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Oxnard |
CALIFORNIA |
93036 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| MILAN K. MADHANI |
4365064 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| HD VEST INVESTMENT SERVICES |
13686 |
| Street Address 1 |
Street Address 2 |
| 1000 Town Center Drive Suite 200 |
| City |
State/Province/Country |
ZIP/Postal Code |
| Oxnard |
CALIFORNIA |
93036 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| PATRICK ROBERT 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 |
| OAKBROOK |
ILLINOIS |
60523 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Peter Fisher |
1259923 |
| (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 |
| OAKBROOK |
ILLINOIS |
60523 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| Keith D Nast |
4533437 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| PROEQUITIES, INC. |
15708 |
| Street Address 1 |
Street Address 2 |
| 43252 WOODWARD AVENUE SUITE 100 |
| City |
State/Province/Country |
ZIP/Postal Code |
| BLOOMFIELD HILLS |
MICHIGAN |
48302 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| ROBERT MARVIN SCHULTZ |
4163450 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| ROYAL ALLIANCE ASSOCIATES, INC. |
23131 |
| Street Address 1 |
Street Address 2 |
| 15821 VENTURA BOULEVARD SUITE 660 |
| City |
State/Province/Country |
ZIP/Postal Code |
| ENCINO |
COLORADO |
91436 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| JOHN KIEM LIONG KWEE |
1531077 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| SAGEPOINT FINANCIAL, INC. |
133763 |
| Street Address 1 |
Street Address 2 |
| 1001 BISHOP STREET SUITE 2300 |
| City |
State/Province/Country |
ZIP/Postal Code |
| HONOLULU |
HAWAII |
96813 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| TONI LYNN SUTHERLAND |
2729672 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| SANDLAPPER SECURITIES, LLC |
137906 |
| Street Address 1 |
Street Address 2 |
| 800 E. NORTH STREET, 2ND FLOOR |
| City |
State/Province/Country |
ZIP/Postal Code |
| GREENVILLE |
SOUTH CAROLINA |
29601 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| TRAWNEGAN GALL |
6266415 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| SANDLAPPER SECURITIES, LLC |
137906 |
| Street Address 1 |
Street Address 2 |
| 1 CITY BOULEVARD WEST SUITE 870 |
| City |
State/Province/Country |
ZIP/Postal Code |
| ORANGE |
CALIFORNIA |
92868 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| GENE ALVIN BREHM |
2815437 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| SAXONY SECURITIES, INC. |
115547 |
| Street Address 1 |
Street Address 2 |
| 7809 Broadway St |
| City |
State/Province/Country |
ZIP/Postal Code |
| San Antonio |
TEXAS |
78209 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| RONALD NORMAN YORK JR |
4308987 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| TRIAD ADVISORS LLC |
25803 |
| Street Address 1 |
Street Address 2 |
| 4814 OUTLOOK DRIVE SUITE 104 |
| City |
State/Province/Country |
ZIP/Postal Code |
| WALL |
NEW JERSEY |
07753 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
| NEW JERSEY |
| NORTH CAROLINA |
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| ANGELA MULLIS BENDER |
5208180 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| TRIAD ADVISORS LLC |
25803 |
| Street Address 1 |
Street Address 2 |
| 4814 OUTLOOK DRIVE SUITE 104 |
| City |
State/Province/Country |
ZIP/Postal Code |
| WALL |
NEW JERSEY |
07753 |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
|
| Recipient |
| Recipient CRD Number |
|
None |
|
| BRIAN RICHARD MARSTON |
733083 |
| (Associated) Broker or Dealer |
|
None |
|
| (Associated) Broker or Dealer CRD Number |
|
None |
|
| WOODBURY FINANCIAL SERVICES, INC. |
421 |
| Street Address 1 |
Street Address 2 |
| 8400 E PRENTICE AVE SUITE 715 |
| City |
State/Province/Country |
ZIP/Postal Code |
| GREENWOOD VILLAGE |
COLORADO |
80111 |
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 |
$84,327,253
|
USD |
|
| Total Amount Sold |
$48,196,912
|
USD |
| Total Remaining to be Sold |
$36,130,341
|
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 |
$4,216,363
|
USD |
|
| Finders' Fees |
$0
|
USD |
|
Clarification of Response (if Necessary):
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):
Estimate of certain fees, including the Dealer Fee, Placement Agent Fee, Acquisition Cost (to affiliates), Acquisition Fee, and offering and organizational expenses that may accrue to one or more Related Persons.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 the issuer 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 Rule 504 or Rule 506 for one of the reasons stated in Rule 504(b)(3) 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 |
| Arizona Healthcare II DST |
Keith Lampi |
Keith Lampi |
President and COO of Sole Member of Signatory Trustee |
2019-01-31 |
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.