Sec 1919 (1-07) Form T-3 For Applications For Qualification Of Indentures Under The Trust Indenture Act Of 1939

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OMB APPROVAL
UNITED STATES
OMB
Number:
3235-0105
SECURITIES AND EXCHANGE COMMISSION
Expires:
February 28, 2019
Washington, D.C. 20549
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hours per response . . . . .43.00
FORM T-3
FOR APPLICATIONS FOR QUALIFICATION OF INDENTURES
UNDER THE TRUST INDENTURE ACT OF 1939
____________________________________________________________________________________________________________________________
(Name of applicant)
____________________________________________________________________________________________________________________________
(Address of principal executive offices)
Securities to be Issued Under the Indenture to be Qualified
Title of Class
A mount
Approximate date of proposed public offering: _______________________________________________________________________________
Name and address of agent for service: _____________________________________________________________________________________
___________________________
GENERAL
1. General Information. Furnish the following information as to the applicant:
(a) Form of organization.
(b) State or other sovereign power under the laws of which organized.
Instruction—Item 1(a). Only a statement as to the legal form of organization is required, such as, “A corporation,’’ “An unincorporated
association,’’ “A common law trust,’’ or other appropriate statement.
2. Securities Act exemption applicable. State briefly the facts relied upon by the applicant as a basis for the claim that registration of
the indenture securities under the Securities Act of 1933 is not required.
Instructions—–Item 2.
1. If the exemption provided by section 3(a)(9) of the Securities Act of 1933 is being claimed by the applicant, there should be
included information as to whether there have been or are to be any sales of securities of the same class by the applicant or by or
through an underwriter at or about the same time as the transaction for which the exemption is claimed and a statement as to any
consideration which has been or is to be given, directly or indirectly, to any person in connection with the transaction and the nature
of any services rendered or to be rendered, directly or indirectly, for such consideration. A statement should also be included as to
the nature of any cash payment made or to be made by any holder of the outstanding securities.
2. If the exemption provided by section 3(a)(10) of the Securities Act of 1933 is being claimed by the applicant, a brief statement
should be given as to the terms and conditions of issuance of the securities to be issued under the indenture to be qualified, including
the basis of exchange of any such securities offered or to be offered for a consideration other than cash only. The court or other state,
territorial or federal authority approving such terms and conditions should be clearly identified and in the case of an authority other
than a court, the statutory provisions concerning the power to grant such approval should be cited. A brief statement should also be
Persons who respond to the collection of information contained in this form are not
SEC 1919 (1-07)
required to respond unless the form displays a currently valid OMB control number.

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