Focus Report Sec Form X 17a 5
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15OMB APPROVAL
OMB Number:
3235-0123
UNITED STATES
Expires:
May 31, 2017
SECURITIES AND EXCHANGE COMMISSION
Estimated average burden
Washington, D.C. 20549
hours per response. . . . . . 12.00
Form
FOCUS REPORT
X-17A-5
(Financial and Operational Combined Uniform Single Report)
PART II
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(Please read instructions before preparing Form.)
This report is being filed pursuant to (Check Applicable Block(s)):
1) Rule 17a-5(a)
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2) Rule 17a-5(b)
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3) Rule 17a-11
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4) Special request by designated examining authority
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5) Other
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NAME OF BROKER-DEALER
SEC FILE NO.
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FIRM I.D. NO.
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ADDRESS OF PRINCIPAL PLACE OF BUSINESS (Do Not Use P.O. Box No.)
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FOR PERIOD BEGINNING (MM/DD/YY)
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(No. and Street)
AND ENDING (MM/DD/YY)
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(City)
(State)
(Zip Code)
NAME AND TELEPHONE NUMBER OF PERSON TO CONTACT IN REGARD TO THIS REPORT
(Area Code) — Telephone No.
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NAMES OF SUBSIDIARIES OR AFFILIATES CONSOLIDATED IN THIS REPORT:
OFFICIAL USE
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DOES RESPONDENT CARRY ITS OWN CUSTOMER ACCOUNTS?
YES
NO
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CHECK HERE IF RESPONDENT IS FILING AN AUDITIED REPORT
EXECUTION:
The registrant/broker or dealer submitting this Form and its attachments and the person(s) by
whom it is executed represent hereby that all information contained therein is true, correct and
complete. It is understood that all required items, statements, and schedules are considered
integral parts of this Form and that the submission of any amendment represents that all
unamended items, statements, and schedukes remain true, correct and complete as previously
.
submitted
Dated the _______________________________day of
_________________________ , _____
Manual signatures of:
1)________________________________________________________________________
____
Principal Executive Officer or Managing Partner
2) ________________________________________________________________________
____
Principal Financial Officer or Partner
3) ________________________________________________________________________
____
Principal Operations Officer or Partner
ATTENTION — Intentional misstatement or omissions of facts constitute Federal
Criminal Violations. (See 18 U.S.C. 1001 and 15 U.S.C. 78:f(a))
Persons who respond to the collection of information contained in this form
are not required to respond unless the form displays a currently valid OMB
SEC 1695 (07-02) 1 of 28
control number.
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