Total No of Units Sold by Licensee Total No. of Units Sold by Licensee in Country X Amount of Licensed Product Sales in Country X in Currency Received Currency Conversion Multiplier, if Applicable, to Convert to U.S. Dollars Amount of Licensed Product Sales in U.S. Dollars REPEAT FOR EACH COUNTRY Total No. of Units Sold by Sublicensee No. 1 Total No. of Units Sold by Sublicensee No. 1 in Country X Amount of Licensed Product Sales in Country X in Currency Received Currency Conversion Multiplier, if Applicable, to Convert to U.S. Dollars Amount of Licensed Product Sales in U.S. Dollars REPEAT FOR EACH COUNTRY REPEAT FOR EACH SUBLICENSEE REPEAT FOR EACH LICENSED PRODUCT TOTAL OF ALL LICENSED PRODUCT SALES IN U.S. DOLLARS For the calendar year in which the quarter being reported falls, report the following for each separate Licensed Product. NAME OF LICENSED PRODUCT BEING REPORTED CALENDAR QUARTER OF 20 TOTAL OF ALL LICENSED PRODUCT SALES in U.S. Dollars LICENSED PRODUCT SALES AT/BELOW $50MIL – Apply 1.5% Rate LICENSED PRODUCT SALES ABOVE $50MIL – Apply 2.5% Rate ROYALTY PAYMENT DUE 1 $ $ $0 $ 2 $ $ $0 $ 3 $ $ $ $ 4 $ $ $ $ TOTALS $ $ $ $ EXHIBIT C WIRE TRANSFER INSTRUCTIONS To send payment to the University of Georgia Research Foundation, Inc. (UGARF) by Automated Clearing House (ACH) or Electronic Funds Transfer (EFT), by Wire, or by SWIFT Transfer, please use the information below. As per Paragraph 3.5, Licensee shall include with any payment made by wire transfer an additional fee of $50.00 U.S. Dollars per wire for any amount originating from a U.S. domestic account and an additional fee of $75.00 U.S. Dollars per wire for any amount originating from a foreign account. For payments by Wire: Pay to the order of: University of Georgia Research Foundation, Inc. Receiving Bank: Synovus Bank/Columbus Bank ABA routing #: 000000000 Beneficiary bank: Synovus Bank
Total No. Nominal Value of Shares Per Share --------- --------- Centennial Cayman Corp. 100 $1.00 SMR Direct Cayman Corp. 100 $1.00 EXHIBIT 3.3(ii) CAPITAL STRUCTURE OF EACH OF THE CHILEAN COMPANIES
Total No. Nominal Value of Shares Per Share --------- --------- Centennial Cayman Corp. 49,999 $1.00 SMR Direct Cayman Corp. 1 $1.00 EXHIBIT 3.3(v) EXCEPTIONS TO OTHER EQUITY INTERESTS See Exhibit 3.1(b). EXHIBIT 3.4
Total No of Training Hours G. Non-Traditional Employment
Total No. Carpet Area of each Apartment sq. mt.(sq ft) 69.70 (750.25) 49.76 (535.62) 48.26 (519.47) 23.78 (255.97) 45.37 (488.36) 23.79 (256.08) 48.27 (519519. 58.58) 49.75 (535.51) 264.13 (2843.10) 124.5 (1340.10) Built Up Area sq. mt. (sq ft) 73.43 (790.40) 52.37 (563.71) 50.83 (547.13) 25.63 (275.88) 48.44 (521.41) 25.63 (275.88) 50.85 (547.35) 52.34 (563.39) 271.849 (29265.09) 127.5 (1372.39) Super Area sq mt. (sq. ft) 89.56 (964.29) 63.89 (687.73) 62.01 (667.50) 31.27 (336.58) 59.10 (636.12) 31.27 (336.58) 62.04 (667.77) 63.85 (687.33) 331.64 (3569.82) 155.5 (1673.78)
Total No. Fem. Number of Adult Males No. Juv. Male Total No. Males Species Totals NR PG L PL SCR NR Myotis lucifugus Myotis septentrionalis Myotis leibii Myotis sodalis Eptesicus fuscus Pipistrellus subflavus Lasiurus borealis Lasiurus cinereus Lasionycteris noctivagans Other – specify: Other – specify: Reproductive Status: NR= nonreproductive, PG= pregnant, L= lactating, PL= post lactating, SCR= scrotal/epididymis swollen. *Complete Measurement and Capture Data Form for all: (1) Myotis sodalis, (2) Myotis leibii, (3) bats you are banding or band recaptures, (4) radio-tagged bats and (5) bat species not usually found in PA. Grand Total Comments:
Total No of figs of each type Please sign below to indicate that you have read and understand the Color Work Agreement Form, and agree to pay the color charges as required: Signature Date Please return this form to:
