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SEC RULE 15c2-6 STATES THAT A TRANSACTION IN A “DESIGNATED SECURITY” IS UNLAWFUL UNLESS THE BROKER-DEALER HAS RECEIVED, PRIOR TO THE TRANSACTION, A SIGNED WRITTEN STATEMENT FROM THE CUSTOMER. A “DESIGNATED SECURITY” IS DEFINED AS A SECURITY SELLING FOR UNDER $5 PER SHARE, HAS NET TANGIBLE ASSETS OF LESS THAN 2 MILLION DOLLARS AND DOES NOT TRADE ON CERTAIN U.S. EXCHANGES OR NASDAQ.
# YEARS INVESTMENT EXPERIENCE: __________________________________________________
TYPE OF SECURITIES PURCHASED: ____________________________________________________
Based on the information listed above we have determined that you have sufficient knowledge and experience to be capable of evaluating the risks of transactions in designated securities. The basis for your suitability determination included:
( ) Sufficient income and net worth
( ) Previous investment experience
( ) Previous investment in designated securities
( ) Stated investment objectives include speculation
______________________________________ IS REQUIRED BY THE ABOVE RULE TO PROVIDE THIS SUITABILITY STATEMENT TO THE CUSTOMER WHO MUST REVIEW THIS STATEMENT, DATE, SIGN, AND RETURN IT ONLY IF IT ACCURATELY REFLECTS THE CUSTOMER’S FINANCIAL SITUATION, INVESTMENT EXPERIENCE AND INVESTMENT OBJECTIVES.
This statement is required by the U.S. Securities and Exchange Commission (SEC) and contains important information on penny stocks. Your broker dealer is required to obtain your signature to show that you have received this statement before your first trade in a penny stock. You are urged to read this statement before signing and before making a purchase or sale of a penny stock.
As required by SEC Rule 15g-2, PLEASE ACKNOWLEDGE RECEIPT of the enclosed four page PENNY STOCK REPORT. THANK YOU.
Date _________________ Signature ______________________________________________________
It is important that this receipt be signed and returned promptly.
CUSTOMER’S WRITTEN AGREEMENT
SEC Rule 15c2-6 states that the trades made by an approved *customer in a designated security must sign a written agreement to the transaction.
LA DISPOSICION 15c2-6 DE LA SEC ESTABLECE QUE LA TRANSACCION DE UN “VALOR NOMINATIVO” ES ILEGAL A MENOS QUE EL AGENTE HAYA RECIBIDO, PREVIAMENTE, UNA DECLARACION ESCRITA FIRMADA POR EL CLIENTE. UN “VALOR NOMINATIVO” SE DEFINE COMO UN VALOR NEGOCIABLE POR UN MONTO MENOR A LOS $5 POR ACCION, RESPALDADO POR ACTIVOS NETOS TANGIBLES POR DEBAJO DE LOS 2 MILLONES DE DOLARES Y QUE NO ES NEGOCIALBE EN CIERTAS BOLSAS DE LOS ESTADOS UNIDOS O NASDAQ.
NOMBRE: __________________________________ Nº DE SEGURO SOCIAL ___________________
DIRECCION (no se acepta un Nº de apartado) _______________________________________________
_______________________________________________
PATRONO Y LA DIRECCION: ___________________________________________________________
EDAD _______________ ESTADO CIVIL _________________ DEPENDIENTES _______________
ESTIMADO DEL INGRESO ANUAL ______________ Y SU FUENTE _________________________
ESTIMADO DEL VALOR NETO DE LA RESIDENCIA ______________________________________
ESTIMADO DEL CAPITAL LIQUIDO NETO _______________________________________________
OBJETIVO DE LA INVERSION: ( ) Grado de la inversión ( ) Especulativo
( ) Buena Calidad ( ) Alto riesgo
COMPAÑIAS DE VALORES ANTERIORES: _______________________________________________
_______________________________________________
AÑOS DE EXPERIENCIA EN INVERSIONES : _____________________________________________
TIPO DE VALORES ADQUIRIDOS: _______________________________________________________
Basados en la información anterior, hemos determinado que usted posee tanto el conocimiento como la experiencia suficientes para evaluar los riesgos involucrados en la transacción de valores nominativos. La base para establecer su idoneidad incluyó:
( ) Ingreso y capital líquido suficientes
( ) Experiencia previa en inversiones
( ) Inversiones previas en valores nominativos
( ) Declaración de los objetivos de inversión incluida la especulación
______________________________________ REQUERIDO POR LA DISPOSICION ANTERIOR CON EL FIN DE EMITIR LA DECLARACION DE IDONEIDAD AL CLIENTE QUIEN DEBE REVISAR, FECHAR, FIRMAR Y DEVOLVER ESTA DECLARACION, SOLAMENTE EN EL CASO DE QUE REFLEJE EXACTAMENTE LA SITUACION FINANCIERA, EXPERIENCIA EN Y OBJETIVOS DE LAS INVERSIONES DEL CLIENTE.
APROBADA: _____________________________
INFORMACION IMPORTANTE SOBRE ACCIONES DE CENTAVOS
Esta declaración es requerida por la Comisión de la Bolsa de Valores (SEC por sus siglas en Inglés) de los Estados Unidos y contiene información importante referente a las acciones de centavo. Su agente está en la obligación de conseguir su firma para demostrar que usted ha recibido esta declaración antes de efectuar su primera transacción con acciones de centavo. Se le ruega leer esta declaración antes de firmarla y de realizar ya sea una compra o venta de un acción de centavo.
Según lo requiere la disposición 15g-2 de la SEC, POR FAVOR ACUSE RECIBO de las 4 páginas incluidas que constituyen el INFORME SOBRE LAS ACCIONES DE CENTAVO. MUCHAS GRACIAS.
Fecha _________________ Firma ______________________________________________________
Es importante que este recibido sea firmado y devuelto lo más pronto posible.
CONSENTIMIENTO ESCRITO DEL CLIENTE
La disposición 15c2-6 de la SEC estipula que las transacciones de valores nominativos realizadas por un cliente autorizado* deben contar con la firma del consentimiento escrito para la transacción.
Computer skills: Windows, Microsoft Office, Word Perfect Office 2000, Corel Draw, Adobe Illustrator, Freehand, Adobe PhotoShop CS 2, Painter IX, Page Maker, Adobe acrobat , Internet Explorer, Netscape, Eudora Pro and image scanning expertise. I have more than 25 years experience as a graphic designer.
Had my own graphic desgining business in Managua, Nicaragua. Worked also for the Nicaraguan National Assembly where very strong international affairs and negotiation skills were developed. Also a strong editing and proofreading skills were to be used particularly on government type terms. The fields I have been exposed the most to are: pharmaceutical, shipping and cargo, newspaper, tourism, call centers, computer schools, computer hardware and software, consulting engineering. Presently working on medical and Stock exchange documents.
Expertise 
CV/Resume (DOC)