Test-the-Waters Intake - Small Change

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Required Company Disclosures

At any time before the filing of an offering statement, an issuer may communicate orally or in writing to determine whether there is any interest in a contemplated securities offering. Such communications are deemed to be an offer of a security for sale for purposes of the antifraud provisions of the Federal securities laws. No solicitation or acceptance of money or other consideration, nor of any commitment, binding or otherwise, from any person is permitted until the offering statement is filed.

The communications must:

State that no money or other consideration is being solicited, and if sent in response, will not be accepted;
State that no offer to buy the securities can be accepted and no part of the purchase price can be received until the offering statement is filed and only through an intermediary’s platform; and
State that a person’s indication of interest involves no obligation or commitment of any kind.

Your answers below will be used to create a testing the waters listing page.

General Information

You can save this form and come back to it later. But you can’t save uploads, so be sure to keep documents on your desktop until you are ready to submit!!

Your name*

First Last

Your email address*

Enter Email Confirm Email

Have you opened a Small Change account?*

If not, go to this link and open an account: https://www.smallchange.co/users/sign_up.

Yes

What would you like to name your offering?*

Your title should be no more than 3 words, preferably two. Pick something upbeat to describe what you are trying to accomplish.

Basic Information About the Company

What is the name of the Issuing Company (the "Company") that will be raising funds?*

By Issuing Company, we mean the entity that will conduct the offering.

What's the Company's phone number?*

What's the Company's email address*

Is (or will) the Company be a Delaware LLC?*

If the answer is no, additional legal fees may be incurred. We encourage you to use a Delaware LLC for this offering if possible.

Yes

Has the Company been created yet?*

Yes

What is the Company's mailing address? Or what will it be?*

Street Address Address Line 2 City State ZIP Code

Upload the entity formation document + EIN letter*

Drop files here or

Accepted file types: pdf, png, jpg, Max. file size: 50 MB.

Director and Officers of the Company

Is (or will) the Manager of the Company be a person, or another Company?*

A person

Another Company

What's their name*

First Last

What's their title?*

What's their email address?*

What's their mobile phone number?*

What's their home phone number?*

What is (or will be) the name of the Managing Company?*

Who will control the Managing Company?*

First Last

What's their title?*

If the Managing Company is an LLC then typically the title will be Manager or Managing Member.

What's their email address?*

What's their mobile phone number?*

What's their home phone number?*

What's their country of citizenship?*

Upload Resume or Bio for Key Person(s)*

Drop files here or

Max. file size: 50 MB, Max. files: 5.

The Company's Business and Business Plan

Upload the latest version of your business plan. At a minimum this must include:

a project narrative,
a market narrative,
a team narrative or your bio,
big picture projections for the project, and
anything else you think is important

Please provide this in original word, excel or powerpoint format for our formatting purposes along with a pdf.

Upload business plan*

Drop files here or

Accepted file types: jpg, png, doc, xlxs, xls, numbers, pdf, pptx, Max. file size: 50 MB, Max. files: 10.

Other Marketing Materials

Upload any other images you would like added to your listing page.

Marketing materials

Drop files here or

Accepted file types: jpg, png, Max. file size: 50 MB.

Phone

This field is for validation purposes and should be left unchanged.

Answering these questions will provide all of the information we need to list your Test-the-Waters campaign.

You can save and return to this form if you bookmark the url. However, uploads cannot be saved, so wait until you are ready to submit before uploading them.

All fields are required to be completed in order to submit.