Ny Form Nf - Uniform Investment Company Notice Filing - 2006 Page 3
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36.
CIK# (EDGAR) ____________________________ Federal ID# (if applicable) ________________________________
Broker-Dealer: _____________________________ Broker-Dealer's CRD No.: _________________________________
Fiscal Year End (if applicable) _________________
7.
[ ] Notice Period: Beginning Date _____/____/____ Ending Date ____/_____/_____
[ ] The issuer elects to have its notice filing made effective upon filing.
[ ] The issuer elects to have its notice filing period begin with SEC effectiveness and thereby agreed to provide the above
state prompt notice of such effectiveness.
8.
Notice Fee $ __________________________________ [ ] No Filing Fee Required
Sales Report Fee (if applicable) $ __________________
Other Fee $ ___________________________________ Explain ____________________________________________
9.
To determine the basis used for calculating the filing fee, provide the following:
[ ] Indefinite Amount
[ ] Definite Amount $_____________________________
[ ] Exemption Filing
[ ] Net Assets: __________________________________
10. For filings to increase the dollar amount of securities reported during the notice period, provide the following:
(1) Previous Amount of Securities _____________________________________
(2) Amount of Increase ______________________________________________
(3) Cumulative Amount of Securities ___________________________________
11. SALES REPORT. If not applicable, place N/A in the blank(s).
Period Covered: Beginning date _____/_____/_____ Ending date _____/_____/_____
Balance at beginning of period $ ___________________________________________
Increases during period
$ ___________________________________________
Amount available for sale
$ ___________________________________________
Sales during the period
$ ___________________________________________
Unsold balance at end of period $ ___________________________________________
12. UNIFORM CONSENT TO SERVICE OF PROCESS (select one)
1. [ ] Was previously filed with state with respect the issuer of the securities by this notice and is incorporated by reference.
2. [ ] Is attached.
3. [ ] Not Applicable (explain): _________________________________________________________________
13. SIGNATURES
The undersigned under penalties of perjury certifies that s/he has executed this Uniform Investment Company notice on
behalf of, and with the authority of the issuer. The undersigned and the issuer represent that the information and statements
contained in the notice filed, are current true and complete to the best of his or her knowledge, information and belief and
that any documents submitted with the notice are true copies of the originals, and that the securities covered by this Notice
are Covered Securities as defined by Section 18(b)(2) of the Securities Act of 1933.
Dated this __________ day of __________________________, ____________________.
Month
Year
For: _______________________________________________ By: _______________________________________________
Name of Issuer
Signature of Authorized Agent of Issuer
________________________________________________
_______________________________________________
Print Name
Title of Agent for Issuer
The filing of this notice constitutes a binding agreement by the above-named issuer and under the laws of the jurisdiction
in which this Form is filed, that upon receipt of a request from such jurisdiction, the issuer will promptly provide a copy
of its current prospectus, and/or statement of additional information, and/or any other document, if any, as filed with the
Securities and Exchange Commission.
IPS Form NF (11/06) Page2 of 2
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