Ny Form Cm-3 - Supplemental Commodity Statement (Page 2 of 4) in pdf

principal is suspended or expelled from membership in any securities or commodities exchange,

association of securities or commodities dealers or investment or commodities trading advisors or

counsel; has a license or registration as a securities or commodity dealer, broker, investment

advisor, salesperson, futures commission merchant, associated person, commodity pool operator

or commodity trading advisor denied, suspended, revoked, cancelled or refused; is enjoined or

restrained by any court or government agency from: the issuance, sale or offer for sale of

securities or commodities, rendering securities or commodities advice or counsel, handling or

managing trading accounts, continuing any practices in connection with securities or

commodities; is convicted of any crime; uses or is known by any other name; is the subject or any

professional disciplinary proceeding; is adjudged a bankrupt or makes a general assignment for

benefit of creditors; is the subject of a receivership or bankruptcy proceeding; is an officer,

director, principal, partner, manager, supervisor or any 10% or more equity holder of any entity

which is reorganized in bankruptcy, adjudged a bankrupt or makes a general assignment for

benefit of creditors; has a judgment entered against them or it which is presently unsatisfied (not

including judgments involving domestic relations); is a party in any litigation or administrative

proceeding in which it is alleged that they or it committed fraud or otherwise violated any

provision of the Martin Act or any other securities or commodities laws? Supply full details and

documentation about the occurrence of any of the above.

4. TERMINATION OR WITHDRAWAL OF REGISTRATION as of __________ date.

Reason: _______________________________________________________

5. CHANGES IN OR TERMINATION OF OFFICERS, DIRECTORS, PRINCIPALS,

PARTNERS, SUPERVISORS, MANAGERS OR ANY 10% OR MORE EQUITY HOLDER.

Use attachments if necessary.

Name: _______________________________

Date of Change: _____________________

Nature of Change: ___________________

Reason for Change: __________________

6. FOR EACH NEW OFFICER, DIRECTOR, PRINCIPAL, PARTNER, SUPERVISOR,

MANAGER OR ANY 10% OR MORE EQUITY HOLDER ATTACH A COPY OF

FORM CI-1.

7. Has new officer, director, principal, partner, supervisor, manager. 10% or more equity holder

of the registrant or any entity in which such individual was a principal ever:

A. been suspended or expelled from membership in any

securities or commodities exchange, association of

securities or commodities dealers or investment or

commodities trading advisors or counsel?.......................... Yes [ ] No [ ]

B. had a license or registration as a securities or commodity

dealer, broker, investment advisor, salesperson, futures

commission merchant, associated person, commodity pool operator

or commodity trading advisor denied, suspended, revoked, cancelled

or refused? .................................................. Yes [ ] No [ ]

C. been enjoined or restrained by an court or

government agency from:

Ny Form Cm-3 - Supplemental Commodity Statement Page 2