Form Ats - Initial Operation Report, Amendment To Initial Operation Report (Page 4 of 5) in pdf

UNITED STATES SECURITIES AND EXCHANGE COMMISSION

Form ATS

Date filed

OFFICIAL

WASHINGTON, D.C. 20549

Page 1

(MM/DD/YY):

USE

INITIAL OPERATION REPORT, AMENDMENT TO INITIAL OPERATION REPORT AND

Execution

ONLY

CESSATION OF OPERATIONS REPORT FOR ALTERNATIVE TRADING SYSTEMS

Page

WARNING: Failure to keep this form current and to file accurate supplementary information on a timely basis, or the failure to keep accurate

books and records or otherwise to comply with the provisions of law applying to the conduct of alternative trading systems would violate

the federal securities laws and may result in disciplinary, administrative or criminal action.

INTENTIONAL MISSTATEMENTS OR OMISSIONS OF FACTS MAY CONSTITUTE CRIMINAL VIOLATIONS

INITIAL OPERATION REPORT

AMENDMENT TO INITIAL OPERATION REPORT

CESSATION OF OPERATIONS REPORT

1. Exact name, principal business address, mailing address, if different, and telephone number of alternative

trading system:

A. Full name of alternative trading system (if sole proprietor, last, first and middle name):

B. Name(s) under which business is conducted, if different from Item 1A:

C. CRD Number:

SEC File No.: 8 -

E. If this filing makes a name change on behalf of the alternative trading system, enter the previous name and

specify whether the name change is of the

________ alternative trading system name (1A), or ________

business name (1B):

Previous name:

Alternative trading system’s main street address (Do not use a P .O. Box):

G. Mailing address (if different):

H. Business telephone and facsimile number:

(Telephone)

(Facsimile)

Contact employee:

(Name and Title)

(Telephone Number)

(F acsimile)

EXECUTION:

The alternative trading system consents that service of any civil action brought by , or notice of any proceeding before, the

SEC or a self-regulatory organization in connection with the alternative trading system’s activities may be given by registered or certified mail

or confirmed telegram, to the alternative trading system’s contact employee at the main address, or mailing address if differen t, given in Items

1F and 1G. The undersigned, being first duly sworn, deposes and says that he/she has executed this form on behalf of , and with the authority

of, said alternative trading system. The undersigned and alternative trading system represent that the information and statements contained

herein, including exhibits, schedules, or other documents attached hereto, and other information filed herewith, all of which are made a part

hereof, are current, true, and complete.

Date:

(MM/DD/YY)

(Name of applicant)

By:

(Signature)

(Printed Name and Title)

Subscribed and sworn before me this _______ day of _________________, __________ by ______________________________

(Month)

(Year)

(Notary Public)

My Commission expires __________________ County of _____________________ S tate of ______________________________

This page must always be completed in full with original, manual signature and notarization.

Affix notary stamp or seal where applicable.

DO NOT WRITE BELOW THIS LINE - FOR OFFICIAL USE ONLY

Form Ats - Initial Operation Report, Amendment To Initial Operation Report Page 4

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