DEMAND FOR INSPECTION OF CORPORATE BOOKS AND RECORDS
The undersigned, _________________________, is the holder of ________ shares of the common stock of _______________________________ and does hereby demand the opportunity to inspect, at the office of the Corporation, the books and records of the Corporation, its stock ledger and the list of its shareholders.
The undersigned ___________________________ does further state that the inspection is sought for a proper purpose, as follows: _____________________________________________________
The undersigned also states that he has never sold nor offered for sale any list of shareholders of any corporation, nor assisted any person in obtaining such a list or record for such purposes.
The requested date and time for inspection is:
Date: _____________________________
Time: _____________________________
__________________________________
Signature of Shareholder
STATE OF ___________________________________
COUNTY OF _________________________________
On ______________________ before me, ____________________ , personally appeared,
personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument.
Witness my hand and official seal.
Signature: __________________________________
(Seal)
Warning:
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