Electronic Filing Of Transfer Agent Forms - Securities And Exchange Commission Page 46
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100APPENDIX A
United States
OMB APPROVAL
Securities and Exchange Commission
OMB Number: 3235-0328
Washington, D.C. 20549
Expires: April 30, 2009
Estimated average burden
hours per response: . .0.15
FORM ID
UNIFORM APPLICATION FOR ACCESS CODES TO FILE ON EDGAR
PART I — APPLICATION FOR ACCESS CODES TO FILE ON EDGAR
Name of applicant (applicant's name as specified in its charter, except, if individual, last
name, first name, middle name, suffix (e.g., “Jr.”)
Mailing Address or Post Office Box No.
City
State or Country
Zip
Telephone number (Include Area and, if Foreign, Country Code) (
)
Applicant is (see definitions in the General Instructions)
Individual (if you check
this box, you must also
Filing
Training
□ Filer
□
□
□ Transfer Agent
□
check either Filer, Filing
Agent
Agent
Agent, Training Agent or
Transfer Agent box)
PART II — FILER INFORMATION (To be completed only by filers that are not
individuals)
Filer's Tax Number or Federal
Doing Business As
Identification Number (Do Not Enter a
Social Security Number)
Foreign Name (if Foreign Issuer Filer and
applicable)
Primary Business Address or Post Office Box No. (if different from mailing address)
46
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