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Name ______________________

Bar # ______________________

Firm ______________________

Address ______________________

______________________

______________________

Telephone ______________________

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Plaintiff,

vs.

Defendant.

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Case No.

Corporate Disclosure Statement

This Corporate Disclosure Statement is filed on behalf of ___________________________

 in compliance with the provisions of: (check one)

____ 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.

____ Rule 12.4(a)(1), Federal Rule of Criminal Procedure, any nongovernmental corporate

party to a proceeding 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.

____ Rule 12.4(a)(2), Federal Rule of Criminal Procedure, if an organizational victim of

alleged criminal activity is a corporation the government must file a statement

identifying the victim and the statement must also disclose the information required

by Rule 12.4(a)(1).

Daniel Slifkin

pro hac vice

Cravath, Swaine & Moore LLP

Worldwide Plaza

825 Eighth Avenue

New York, NY 10019

(212) 474-1000

Richard Di Donato, individually and on behalf of all others similarly situated,

16-cv-302-NVW

Insys Therapeutics, Inc.; Michael L. Babich;

Darryl S. Baker; and John N. Kapoor

Defendants

✔

Case 2:16-cv-00302-NVW Document 20 Filed 03/15/16 Page 1 of 2
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The filing party hereby declares as follows:

____ No such corporation.

____ Party is a parent, subsidiary or other affiliate of a publicly owned corporation as

listed below. (Attach additional pages if needed.)

______________________________________ Relationship__________________________

____ Publicly held corporation, not a party to the case, with a financial interest in the

outcome. List identity of corporation and the nature of financial interest. (Attach

additional pages if needed.)

__________________________________________ Relationship______________________

_____ Other(please explain)

________________________________________________________________________

___________________________________________________________________________

A supplemental disclosure statement will be filed upon any change in the

information provided herein.

Dated this _________ day of __________________, ________.

_______________________________

Counsel of Record

Certificate of Service:

✔

15th March 2016

s/Daniel Slifkin

I hereby certify that on March 15, 2016, I electronically transmitted the foregoing

document to the Clerk’s Office using the CM/ECF System for filing and transmittal of

a Notice of Electronic Filing to the following CM/ECF registrants:

Francis J. Balint, Jr.

Andrew S. Friedman

BONNETT FAIRBOURN FRIEDMAN & BALINT, P.C.

2325 E. Camelback Road, Suite 300

Phoenix, Arizona 85016

Attorneys for Plaintiff

Case 2:16-cv-00302-NVW Document 20 Filed 03/15/16 Page 2 of 2