Fillable X-17a-5 Part Ii A (Page 9 of 9) in pdf

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FINANCIAL AND OPERATIONAL COMBINED UNIFORM SINGLE REPORT

PART IIA

BROKER OR DEALER

as of _____________________

EXEMPTIVE PROVISION UNDER RULE 15c3-3

24. If an exemption from Rule 15c3-1 is claimed, identify below the section upon which such exemption is based (check one only)

A. (k)(1) — $2,500 capital category as per Rule 15c3-1 .................................................................................................................

4550

B. (k)(2)(A) — “Special Account for the Exclusive Benefit of customers” maintained .......................................................................

4560

C. (k)(2)(B) — All customer transactions cleared through another broker-dealer on a fully disclosed basis.

Name of clearing firm

4335

4570

D. (k)(3) — Exempted by order of the Commission (include copy of letter) ......................................................................................

4580

Ownership Equity and Subordinated Liabilities maturing or proposed to be withdrawn within the next six months

and accruals, (as defined below), which have not been deducted in the computation of Net Capital.

Type of Proposed

Amount to be

Withdrawal or

Withdrawn (cash

(MMDDYY)

Expect

Accrual

Insider or

amount and/or Net

Withdrawal or

(See below

Outsider?

Capital Value of

Maturity

Renew

for code )

Name of Lender or Contributor

(In or Out)

Securities)

Date

(Yes or No)

4600

4601

4602

4603

4604

4605

4610

4611

4612

4613

4614

4615

4620

4621

4622

4623

4624

4625

4630

4631

4632

4633

4634

4635

4640

4641

4642

4643

4644

4645

Total $

4699

OMIT PENNIES

Instructions: Detail Listing must include the total of items maturing during the six month period following the report date, regardless of whether or not the capital contribution is

expected to be renewed. The schedule must also include proposed capital withdrawals scheduled within the six month period following the report date including

the proposed redemption of stock and anticipated accruals which would cause a reduction of Net Capital. These anticipated accruals would include amounts of

bonuses, partners’ drawing accounts, taxes, and interest on capital, voluntary contributions to pension or profit sharing plans, etc., which have not been deducted

in the computation of Net Capital, but which you anticipate will be paid within the next six months.

WITHDRAWAL CODE:

DESCRIPTIONS

Equity Capital

Subordinated Liabilities

Accruals

SEC 1696 (02-03) 15 of 16