SCORN ts lott hapten gee go ec vestedgnd!1 29967 ,00D12867 tiey and Dxchange Cremission hs not necessarily revigwett ke information i this ing} anv sot deteuanined if ts accurate ane complote, ‘The vender should noc aasumte Tha the infortnation is accurate and complete. UNITED STATES SECURITIES ANI ‘COMMISSION Weshlngion, DS. 208548 FORM D Natlce of Exempt Offering of Securities ID EXCHANGE FCA APPROVAL Previn 2K (Fle 1D Nome [none cauo1299671 (inca Namo of incar cuines: Jisicen of incorporaton/Orgaricatin, RL AWARR Year af lsnnparatontOgrization, ove Fe Yea 90 [Jin ae Five ve Spy Yea) [lvetto be rernea Erincipal i 3 t Bucinass aad Contact nformation —— ame of fate cameinn ase nity Type Cites Parnes ata Uy Cor omny ite Parnerio {[Jasinoss Tass [lover cspact Strut Ades 1 ‘sweet nearoes 518 SY PIRSTL AVENUE, sUITEsst ot SisleProvircatcuniry Z'P/Posta Prono Humor af Issuer PORULANE, ORFGON ran sin aiRaee esi Last Name Fst Rama Hiymate as Sret Adiege 1 Street Alene 2 (515 9 FNk Aveo suite cy StalxProunesiGouty asasnas date wane Mt ‘ikiPestlode vats ess AMM SEC FORM 2et? Heaton DRHAON Retains Exeutvn one bec frratar toe govA shinai 2896100012596 1 yrronsaca Ceston of ene Necessary Veta Ft xe Shon: Aden 4 Shasta 2 SSS Pah ae oy StatPeainesCounty atone sects ose fect ]Prmcee Clartzation of Reeponce (f Necestant) taste Name , ZiPiPeata\Coda Last Nome stare Jun, tind Suen Aadrace | ‘Stvot addons 2 SII SP ER Ae, ane cy StatetProvince/Courey Pada ene Relations in ‘arieation of Response Necessary. emt onc f}acre Proce Widete Name ZPiPostslcode SP Sk Last tena Name ve stig Sree: Ades Suet Ades 2 (SIs Nt sess ly SuwPeoshestouy Tete oxen ettacanpe exo omer cuccr[ froma Clarfeation of Response ff eosssan): Wide Namo PAPostalCode ‘rank 5105 Last blame Pst ame Wt tc ‘StaotAdrass Sivan Adios 2 Lesa Hh Ave sta iy SratePrevioea/Courey Pont OKLUON ato [eww onowfs ne ‘Gurication of Response (4 Nacosser) [rrr Wie Nae , ZiPiPeetstCods ran 36 tis Sus AML SRCRORM T Bott uprenerse gostei 18965 0001299671, par 1 Sean [eateutine Banking 8 nancial Sonvens — [event ag eset eg Jpootee Invosimest Fur Ins nut oir ot ‘he stv Gros diate? Lh» Dre [loner smn & Fran! Sevens [Jevsnosssences oer Joo i [Jee ues [Jeneray consorvation cnn Sees lors cas other Leroy issase See overs Range [ho Revers [st -sr.2caans lptaag.0at ss.000,000 Iss.c06 001 524,0¢0,a00 525,000,401 - 190,800,000 [ever s:01,c00,000 oR Heath Cae [aerstotey Direct insurance Lites yscirs [Jrrsrmacetiis eal Estate 7 [Jeonmert [Joonstucion [ret & ines [reste tehndoay [Jesnoutee [Jonseracnatoay Tone [Jats & aos [esas & conoatone [Jr 8 art Sens [Jorer nave [loter [lovin na: estate purge Ho Atl vu Rerge [Je orgs et seve [Jet -s5000 9 [Jesenaos -s2sone.con [Joes et -ssnc0n.a0 Do: $100,000,000 tia gets aan srcroem ® Ipsos gow/Aecivevocgn dat 128667:000129007] Fscineorisacse [Joccine ise []vatanotsate [vet Aentcette ula SCAb}e}y foot. (oF) ute $04 (ein [rue cor ex [Tsscurtin set estin 46 [Jaaesod oxo [eines comasny ct ton [Dsechener [oeensiae [Jsesicnsicy2) [sarin cierto [eecter stays) [Jexcton axe Tectonatain Fleseinnaexea [Jocoienatexs) [Jsvetea sexta; [[sccien sexs) []ooction sit} [[sectonsein Hype ating ew oon ne of Fit Sale 012124: [at Sale Yao Coca [ferern Bieta Toren oe Ieee tran ots wat now tan on yea? [ie Peni [JPost tvesusent und nee ares [Jressn--cenmeon Scurter Opin, Wavantr Otmc Rte ACAUHEARIN [Tau aera Pepenyeualios {lees [rrr eno soo sucusty tw be Acqivod Upon Rxerles of Catan, JMsrentor thar Right be Acquire Secu Is this ofr being mci n eoonecton witha iushess oanthatian troraaeton, euch as 8 marge, acqu‘efon er sxchanga efor? aor unasacr3 am SHE FORM D aoe etna ac L267 ODO ZSO6T1 Sut Clarfcation of Resronse i Necessary} Redpiem (hesocietc) Broker or Das Seat Adress 1 Sirst Adevess 2 2sPoxtel cay SialeP-evinostCouny ae ‘Stull of Soleation (sect eat eh) lan ‘Sheck "States of crock suas inclu Stns Deri {5 Ciering and Sales Avena Tel Oeing cin: 84,907 U60 oe[ dete loslancanisia soma" US0 Tela Remain fobe Sot BL USD er[ ee ‘ioc of Rosponsa i Hecassary: rare Select if secuilies in the cileriny have been ur may be gold te persons why de nit qua fy fs sco sur en too eh ntasseated rena oho Satay nove ested te eng Pearls of eter curse ong ale bot ot nay be sods patent na ff——"“4 thug ar arosicd mason tr tal nave’ otentreune sere tove Pome imate nthe sag Giles Commissions & Findo's Poos Expenses ravi separately ho ameunts of ses commisians and finders fees expenses, fan the amet af an cexponduve iro! knever, provide an estate and check the box next othe amcunt, tos cman Uso []ex-ata Fntes Feo 36.us [tnt ‘Phartcation of Response (i Hscessary ‘iSieeatPreceads euisgtsan. Sec HORN tases se. gpeP ceed 20067 DDDIDONGTL ot? rove tho amwunl of Ihe gtoae proceed of tho offering thet has been orf provesed to be uted for payments to any ofthe persons reu'red sabe rammed 93 pecutoaiteors, decors os prematara in eepones to Ram 2 bu te amount Is anknown, provide an estimate ard check the Box raxt athe smcank uso []éntinne ‘Cloiteatin of Resposse if Necessary ‘Bighabité ana Sibson Pleaee verly the lnformaton you have enteral and raviaw the Terma of Submfsslan hetow before signing and clleking SUBIIT helow to file this netics. ‘Torms of Subnizsion In submiltag this notice, each lsver named shovel 1 Nattying he SEC andi aach State In which this noteei# Me of he fering of ascariee described ara undertaking > fresh (ern, pn wll, fe.ses, she acordance wh spinal, the irfonmion faan'ched ie forans* lrovocably appciting oach of ne Sacrolany of the SFC ad, he Secul-es Awulnsalon or wher legally signed oficer cf te Sloe in when the Issuctmealnzin ks Rrnapal place of aue'ness and ny Stale inwhion ths nace ld, a is geal ur servic cf process, and agreeing at Taeee persans nis avecpl sar on its Esha, cf any notice. processor olerding, an firth agreeing fal such venice ‘ray hee made by resetered at cected mol in any Ledralo: sale ace, admipistarve proceeding, of sanalon revght against tn ay piace sudoct oth trae ion of United States, # te acon, precescing or aritatian (3) ais out of any acta eennrson wth he exoing of soot tna lt satjen of his noliee, avd (2) founda. recy irdvaety, uoon th provsone c® he Secuien ‘Avtof 1890, tre Cocwilas Enchaage Act of 1834, fae Trt Inds Act of 230, ‘he vesinen: Company Act of 190, o he Invaetment Adveere Act of 1940, or any rile or rgitaten dndor any oF ‘rage matter, ord the as cf the Stale hick: sh eevee rena its principal place of bosinees or ‘ny Sizlvin hich tis nalco =f. Certiyng thal, # the esaeriaesint'ng @ Fle 5CS examin, the ket” fs no cuales Fon: aig on Rule £05 far one cite reasons stated a ule CSG) 2A Each Issue: lente above has read thisnatco, kaows the wants to va tg, and has duty cauaed tis noice “oe sled on ils bohet by the Urdorsigr ac duly suherized arson ot signatro, typi he signer's name cr athe ltlersor characters aepted e+ authorize a6 the signe's signature a IL Bae [ELINICIEN TRO Yar var fcan Minos IPO, Seaein, mee OTIS Persons who respond to the colloction of information contained in this form are not required fo respond unless the orm displays « curently valid OMB: aun. nrsacts ana sro FORM.D gst ae gd Ache 122957 COL2I96 108? TBR AM