Form U-1 - Uniform Application To Register Securities Page 5
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5FOR AN ACKNOWLEDGEMENT OF THE FILING OF THIS
APPLICATION COMPLETE THE FOLLOWING
Name and address of correspondent:
___________________________________________________________________________________
___________________________________________________________________________________
Applicant: __________________________________________________________________________
Issuer: _____________________________________________________________________________
State of: ___________________________________
File Number: ________________________
Examiner: ___________________________________________________________________________
Telephone: __________________________________________________________________________
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Parent category: Legal