Form 133.12 - Renewal Application For Mutual Funds And Other Continuous Offerings

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Form
TEXAS PERMIT NO.
133.12
EXPIRATION DATE
F.Y. END DATE
Texas State Securities Board
P.O. Box 13167
Austin, Texas 78711-3167
Renewal Application for Mutual Funds and Other Continuous Offerings
Must be submitted with the applicable renewal fee.
[This form must be filed at least one month before the expiration of a current permit.]
1.
Name of Issuer. This name must be the same as that shown on Texas permit:
2.
Principal address of Issuer:
3.
Correspondent:
Firm:
Address:
Telephone: (
)
4.
Describe any legal or administrative proceedings of a material nature that have been
instituted in which the Issuer, its advisor, or any affiliate was named as a party. If you have
not previously notified the State Securities Board of such proceedings, please attach a
summary or copy of the pleadings.
02-24-2004

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