The following form shall be filed by franchisors claiming exemptions under Regulation .10D, E, F, or G of this chapter:
FORM F-1
NOTICE OF EXEMPTION UNDER THE MARYLAND FRANCHISE REGISTRATION AND DISCLOSURE LAW
Pursuant to COMAR 02.02.08.10 a
This Notice of Exemption shall be accompanied by a filing fee of $250.00 payable by check to: Office of the Attorney General. This Notice shall be considered filed with the Division for purposes of COMAR 02.02.08.10 a as of the date on which the Notice is received by the Division or, if received by the Division after the date on which it is due, as of the date prior to the due date on which it was mailed by means of United States registered or certified mail to the Maryland Division of Securities, Office of the Attorney General, 200 St. Paul Place, 20th Floor, Baltimore, Maryland 21202-2020.
This form is being filed to claim the following exemption from the registration requirements of the Maryland Franchise Registration and Disclosure Law. (CHECK ONE)
_______02.02.08.10D -S (If relying on this exemption, include with this filing the financial statements required by this regulation.) _______02.02.08.10E -S _______02.02.08.10F -I _______02.02.08.10G -E (If relying on this exemption, include with this filing a copy of the Commissioner's order.)
1. Franchisor Name:Complete mailing address, telephone number, and facsimile number of Franchisor: Mailing Address: Telephone:()Facsimile:()2. Name of Correspondent to whom communications regarding this Notice should be directed:Complete mailing address, telephone number and facsimile number of Correspondent: Mailing Address: Telephone:()Facsimile:()3. Describe briefly the type of franchise being offered:4. Franchisor's type of business organization:CorporationPartnershipOther (describe)5. Name of Offeree (if applicable): Complete mailing address, telephone number, and facsimile number of Offeree:
Mailing Address:
Telephone: (___) ________________________
Facsimile: (___) ________________________:
6. In the event that (a) the Franchisor, (b) any of its officers, directors, or general partners, (c) any franchise broker offering or selling its franchises in Maryland, or (d) any salesperson offering or selling its franchises in Maryland, is or has been the subject of any of the following actions or events, please provide the detailed information requested (attach additional sheets):A. Pending administrative, civil, or criminal actions alleging a violation of any franchise law or regulation, fraud, embezzlement, fraudulent conversion, restraint of trade, unfair or deceptive practices, misappropriation of property or any comparable allegations:NOYES (ATTACH DETAIL)B. During the 10-year period immediately preceding the date of the offering circular: (1) A conviction of a felony or a plea of nolo contendere to a felony charge or a finding of liability in a civil action if such felony or civil action involved a violation of any franchise law, fraud, embezzlement, fraudulent conversion, restraint of trade, unfair or deceptive practices, misappropriation of property, or any comparable violations of law:NO YES (ATTACH DETAIL)(2) Any consent judgment, decree, or order or assurance under a franchise, securities, antitrust, monopoly, trade practice, or trade regulation law:NO YES (ATTACH DETAIL)(3) Any order of any national securities association or national securities exchange (as defined in the Securities Exchange Act of 1934) suspending or expelling such persons from membership in such association or exchange:NOYES(ATTACH DETAIL)C. With respect to each question above answered "Yes", state:(1) The name of each person or entity involved;(2) The court, agency, association, or exchange involved;(3) A summary of the allegations;(4) If applicable, the date of the conviction, judgment, decree, or order or assurance; and(5) The penalty imposed, damages assessed and nature thereof, terms and conditions of the judgment, decree, or order or assurance. DATE
AUTHORIZED SIGNATURE
PRINTED NAME OF SIGNATORY Complete mailing address, telephone number, and facsimile number if different from item 2 above: ()
Md. Code Regs. 02.02.08.11
Regulations .11 recodified and amended effective May 19, 1986 (13:10 Md. R. 1154)
Regulations ______ .11 under COMAR 02.02.10 repealed effective January 17, 1994 (21:1 Md. R. 27)
Regulations .11 adopted effective January 17, 1994 (21:1 Md. R. 27)
Regulation .11 amended effective June 29, 1998 (25:13 Md. R. 992)