Annotated Form 144

Notice Of Proposed Sale Of Securities
Pursuant To Rule 144
Under The Securities Act Of 1933

Instructions

  • Attention: Transmit for filing 3 copies of this form concurrently with either placing an order with a broker to execute sale or executing a sale directly with a market maker.

  • See the definition of  "person" in paragraph (a) of Rule 144. Information is to be given not only as to the person for whose account the securities are to be sold but also as to all other persons included in that definition. In addition, information shall be given as to sales by all persons whose sales are required by paragraph (e) of Rule 144 to be aggregated with sales for the account of the person filing this notice.

Basic Information

1a
  • Name of Issuer
1b
  • Issuers IRS identification number
1c
  • Issuers SEC file number, if any
--
  • Instruction: The person filing this notice should contact the issuer to obtain the IRS Identification Number and the SEC File Number
1d
  • Issuers address, including zip code
1e
  • Issuers telephone number, including area code
2a
  • Name of person for whose account the securities are to be sold
2b
  • Such persons IRS identification number, if such person is an entity
2c
  •  Such persons relationship to the issuer
  • e.g., officer, director, 10% stockholder, or member of immediate family of any of the foregoing
2d
  • Such persons address, including zip code
3a
  • Title of the class of securities to be sold
3b
  • Name and address of each broker through whom the securities are to be offered or each market maker who is acquiring the securities
3c
  • Number of shares or other units to be sold
    (if debt securities, give the aggregate face amount)
3d
  • Aggregate market value of the securities to be sold
    as of a specified date within 10 days prior to filing of this notice
3e
  • Number of shares or other units of the class outstanding,
    or if debt securities the face amount thereof outstanding,
    as shown by the most recent report or statement published by the issuer
3f
  • Approximate date on which the securities are to be sold
3g
  • Name of each securities exchange, if any, on which the securities are intended to be sold

Table I - Securities to be sold

Furnish the following information with respect to the acquisition of the securities to be sold and with respect to the payment of all or any part of the purchase price or other consideration therefor:
 

  • Date you acquired

  • Nature of acquisition transaction

  • Name of person from whom acquired
    (If gift, also give date donor acquired)

  • Amount of securities acquired

  • Date of payment

  • Nature of payment

  • Instructions: If the securities were purchased and full payment therefor was not made in cash at the time of purchase, explain in the table or in a note thereto the nature of the consideration given. If the consideration consisted of any note or other obligation, or if payment was made in installments describe the arrangement and state when the note or other obligation was discharged in full or the last installment paid.

Table II - Securities sold during the past 3 months

Furnish the following information as to all securities of the issuer sold during the past 3 months by the person for whose account the securities are to be sold.
 

  • Name and address of seller

  • Title of securities sold

  • Date of sale

  • Amount of securities sold

  • Gross proceeds

  • Remarks:

Dates; Signatures

  • ____________________
    Signature

  • The notice shall be signed by the person for whose account the securities are to be sold. At least one copy of the notice shall be manually signed. Any copies not manually signed shall bear typed or printed signatures.

  • Attention:
    The person for whose account the securities to which this notice relates are to be sold hereby represents by signing this notice that he does not know any material adverse information in regard to the current and prospective operations of the Issuer of the securities to be sold which has not been publicly disclosed. If such person has adopted a written trading plan or given trading instructions to satisfy Rule 10b5-1 under the Exchange Act, by signing the form and indicating the date that the plan was adopted or the instruction given, that person makes such representation as of the plan adoption or instruction date.  [See Form 144: Reliance on Rule 10b5-1(c)]

  • Attention: Intentional misstatements or omission of facts constitute Federal Criminal Violations (See 18 U.S.C. 1001)