Exit Report Under Regulation a (1-z)
June 26 2018 - 9:30AM
Edgar (US Regulatory)
Form 1-Z Issuer Information
FORM 1-Z
UNITED STATE
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 1-Z
EXIT REPORT UNDER REGULATION A
OMB Number: ####-####
Estimated average burden hours per response: ##.#
1-Z: Filer Information
Is this filing by a successor company pursuant to
Rule 257(b)(5)
resulting from a merger or other business
combination?
o
Yes
x
No
Is this a LIVE or TEST Filing?
x
LIVE
o
TEST
Is this an electronic copy of an official filing
submitted in
paper format?
o
Would you like a Return Copy?
o
Submission Contact Information
Notify via Filing Website only?
o
1-Z: PRELIMINARY INFORMATION
Exact name of issuer as specified in the issuer's
charter
Solera National Bancorp, Inc.
Address of Principal Executive Offices
Address 1
319 South Sheridan Boulevard
Commission File Number(s)
1-Z: PART I Summary Information Regarding the Offering and
Proceeds
Summary Information
Date of qualification of the offering statement
Date of commencement of the offering
Amount of securities qualified to be sold in the
offering
Amount of securities sold in the offering
The portion of aggregate sales attributable to
securities sold on behalf of the issuer
The portion of aggregate sales attributable to
securities sold on behalf of selling securityholders:
Fees in connection with this offering and names of service
providers.
Underwriters - Name of Service Provider
Underwriters - Fees
Sales Commissions - Name of Service Provider
Sales Commissions - Fee
Finders' Fees - Name of Service Provider
Finders' Fees - Fees
Audit - Name of Service Provider
Eide Bailly LLP; Fortner, Bayens, Levkulich & Garrison, P.C.
Audit - Fees
Legal - Name of Service Provider
Shapiro Bieging Barber Otteson LLP; Merrill Corporation
Legal - Fees
Promoters - Name of Service Provider
Promoters - Fees
Blue Sky Compliance - Name of Service Provider
Shapiro Bieging Barber Otteson LLP
Blue Sky Compliance - Fees
CRD Number of any broker or dealer listed
Net proceeds to the issuer
Clarification of responses (if necessary):
1-Z: PART II Certification of Suspension of Duty to File Reports
Certification
Title of each class of securities covered by this Form
Commission File Number(s)
Approximate number of holders of record as of the
certification date
1-Z: Signature
Signature
Pursuant to the requirements of Regulation A,
(Name of issuer as specified in charter)
Solera National Bancorp, Inc.
certifies that it meets all of the conditions for termination
of
Regulation A reporting specified in Rule 257(d) and that there
are
no
classes of securities other than those that are the subject
to
this
Form 1-Z regarding which the issuer has Regulation A
reporting
obligations.
(Name of issuer as specified in charter)
Solera National Bancorp, Inc.
Has caused this certification to be signed on its behalf by the
undersigned duly authorized person.
Instructions: This Part II of Form 1-Z is required by Rule 257(d)
of Regulation A. An officer of the issuer or any other duly
authorized person may sign, and must do so by typed signature. The
name and title of the person signing the form must be typed or
printed under the signature. The signatory to the filing must also
manually sign a signature page or other document authenticating,
acknowledging or otherwise adopting his or her signature that
appears in the filing. Such document must be executed before or at
the time the filing is made and must be retained by the issuer for a
period of five years. Upon request, the issuer must furnish to the
Commission or its staff a copy of any or all documents retained
pursuant to this instruction.
Solera National Bancorp (PK) (USOTC:SLRK)
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