2.
Date on which the undersigned shall become subject to the electronic filing requirements
of the Instrument:
________________________________________
Part III: Contact Person
Name and telephone number of person to contact with respect to this notification:
_________________________________________________(_______ )__________________
Name
Area Code
Telephone No.
DATED this__________________________________day of ________________, _________.
_______________________________________
(Name of Electronic Filer or Filing Agent - please
print)
_______________________________________
(signature)
_______________________________________
(Official Capacity - please print)
_______________________________________
(Please print here name of individual whose signa-
ture appears above, if different from name of elec-
tronic filer or filing agent printed above)