ENTITY Form 5-09
PREPARED BY REVIEWED BY
REVISION DATE SECTION PAGE
CAPITALIZATION - BONDS
DESCRIPTION ISSUE OF
DISTRIBUTION OF BONDS
Number Of Bondholders
Denomination $ per bond $ per bond
Interest rate % %
Are payments current?
Are bonds secured or unsecured?
Are payments subordinated?
If so, to what?
Is there a sinking fund requirement?
Are there serial maturities?
Do these bonds participate in earnings?
Will bonds have voting rights if payments are in default?
Were warrants attached to these bonds?
If so, for how many shares?
When can they be exercised?
What is the exercise price?
Are these bonds convertible into common stock?
Are there staggered conversion dates and prices?
What is the earliest conversion date?
What is the earliest conversion price?
Are these bonds callable?
Are there staggered call dates and prices?
What is the earliest call date?
What is the earliest call price?
Who were the lead underwriters?
Public or private placement?