Form Njbos-6 - Registration Statement For Registration By Notification - State Of New Jersey

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NEW JERSEY BUREAU OF SECURITIES
153 Halsey Street, 6
Floor
th
PO Box 47029
Newark, NJ 07101
(973) 504-3600
NEW JERSEY REGISTRATION STATEMENT
FOR REGISTRATION BY NOTIFICATION
All items must be answered. Attach riders where necessary.
I. DESCRIPTION OF ISSUER
A. Name: ________________________________________________________________
B. Address: ______________________________________________________________
C. Form of organization:
State: ___________________________________________________
Date organized: ___________________________________________
D. General character of business: _____________________________________________
______________________________________________________________________
E. Principal place of business: _______________________________________________
______________________________________________________________________
II. DESCRIPTION OF SUBSIDIARIES
(State the information requested in Question I for each significant subsidiary of the issuer.)
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
III. DESCRIPTION OF APPLICANT
(Complete if applicant is not the issuer.)
A. Name: ________________________________________________________________
B. Address: ______________________________________________________________
C. Relationship to issuer: ___________________________________________________

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