Clinicient 2012 Form D

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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

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sucusty tw be Acqivod Upon Rxerles of Catan,
JMsrentor thar Right be Acquire Secu

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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

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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
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nrsacts ana
sro FORM.D

gst ae gd Ache 122957 COL2I96

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