Electronic Filing Of Transfer Agent Forms - Securities And Exchange Commission Page 66
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10010(h)(1)(iii). Date of
10(h)(1)(ii). Title of Action
Action
10(h)(1)(iv). The Court or body taking the Action and its location
10(h)(1)(v). Description of the Action
10(h)(1)(vi). The disposition of the Proceeding
10(i). Does the applicant or a control affiliate have any unsatisfied
Yes
No
judgments or liens against it? . . . . . . . . . . . . . . . . . . . . . . . . . .
10(i)(1)(i). The individuals named in the Action
10(i)(1)(iii). Date of
10(i)(1)(ii). Title of Action
Action
10(i)(1)(iv). The Court or body taking the Action and its location
10(i)(1)(v). Description of the Action
10(i)(1)(vi). The disposition of the proceeding
ATTENTION: INTENTIONAL MISSTATEMENTS OR OMISSIONS OF FACT
CONSTITUTE FEDERAL CRIMINAL VIOLATIONS. See 18 U.S.C. 1001 and
15 U.S.C. 78ff(a)
SIGNATURE: The registrant submitting this form, and as required, the SEC
supplement and Schedules A-D,
And the executing official hereby represent that all the information contained
herein is true, correct and complete.
11(a). Signature of Official responsible for Form: 11(b). Telephone Number:
11(d).Date Signed
11(c). Title of Signing Officer:
(Month/Day/Year):
66
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