Form Ta-1 - Uniform Form For Registration As A Transfer Agent And For Amendment To Registration Pursuant To Section 17a Of The Securities Exchange Act Of 1934

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Regulator File No.
OMB APPROVAL
OMB Number:
3235-0084
Expires:
April 30, 2012
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UNITED STATES
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SECURITIES AND EXCHANGE COMMISSION
Washington, D. C. 20549
FORM TA-1
UNIFORM FORM FOR REGISTRATION AS A TRANSFER AGENT AND FOR AMENDMENT
TO REGISTRATION PURSUANT TO SECTION 17A OF THE
SECURITIES EXCHANGE ACT OF 1934
GENERAL: Form TA-1 is to be used to register or amend registration as a transfer agent with the Comptroller of the Currency,
the Board of Governors of the Federal Reserve System, the Federal Deposit Insurance Corporation or the
Securities and Exchange Commission pursuant to Section 17A of the Securities Exchange Act of 1934. Read
all instructions before completing this form. Please print or type all responses.
1. Appropriate regulatory agency (check one) (See General Instruction D):
Comptroller of the Currency
Board of Governors of the Federal Reserve System
Federal Deposit Insurance Corporation
Securities and Exchange Commission
2. Filing status of this form (check one):
Registration
Amendment to Registration
3.a. Full name of registrant:
________________________________________________________________________________________________________
Previous name, if being amended:
________________________________________________________________________________________________________
b. Financial Industry Number Standard (FINS) number (See Special Instruction A1):
________________________________________________________________________________________________________
c. Address of principal office where transfer agent activities are,
e. Telephone Number:
or will be, performed (See Special Instruction A2):
(Include Area Code)
(Number and Street)
(City)
(State)
(Zip Code)
______________________________________________________________________________________________________
d. Mailing address, if different from response to Question 3c:
4. Does registrant conduct, or will it conduct, transfer agent activities at any location other
Yes
No
than that given in question 3c above? If “yes,” provide address(es):
5. Does registrant act, or will it act, as a transfer agent solely for its own securities and/or
Yes
No
securities of an affiliate(s)? (See Special Instruction A5)
Persons who are to respond to the collection of information
SEC 1528 (9-01)
contained in this form are not required to respond unless the
form displays a currently valid OMB control number.

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