John Q Attorney, #9999

123 Main Street, Suite 100

Salt Lake City, Utah 84111

(801) 555-5555

IN THE UNITED STATES DISTRICT COURT

DISTRICT OF UTAH - CENTRAL DIVISION

______________________________________________________________________________

:

JOHN DOE,	:

Plaintiff	:	RULE 7

:	CORPORATE DISCLOSURE

v.	:	STATEMENT

:

:

ABC CORPORATION,	:

Defendants	:	Civil No. <Case Number>

:

______________________________________________________________________________

This Corporate Disclosure Statement is filed on behalf of <Plaintiff or Defendant Name> in compliance with the provisions of Rule 7.1, Federal Rules of Civil Procedure, a nongovernmental corporate party to an action in a district court must file a statement that identifies any parent corporation and any publicly held corporation that owns 10% or more of its stock or states that there is no such corporation.

The filing party hereby declares as follows:

____ No corporation owns 10% or more of its stock.

____ Party is a subsidiary or other affiliate of a privately held parent corporation that owns 10% or more of its stock.

Parent:_________________________ Relationship_____________________

_____ Party is a subsidiary or other affiliate of a publicly held corporation that owns 10% or more of its stock.

Parent: <Parent Name> Relationship: Parent - 100% owner

A supplemental disclosure statement will be filed upon any change in the information provided herein.

Dated this ___ day of _________, 20__

_________________________

John Q. Attorney