Sec 1919 (1-07) Form T-3 For Applications For Qualification Of Indentures Under The Trust Indenture Act Of 1939 (Page 2 of 5) in pdf

given as to the manner in which notice of a right to appear at the hearing on the fairness of the plan before such court or other

authority has been or will be given to, all persons to whom it is proposed to issue securities in such exchange.

AFFILIATIONS

Affiliates. Furnish a list or diagram of all affiliates of the applicant and indicate the respective percentages of voting securities or

other bases of control.

Instructions—Item 3.

1. Attention is directed to the definition of the term “affiliate’’ in Reg. §260.0-2 of the General Rules and Regulations under the Act.

The term “voting security’’ is defined in section 303(16) of the Act. See also Rule 7a-26.

2. If the indenture securities are to be issued in connection with, or pursuant to, a plan of acquisition, succession or reorganization, the

information shall also be given, so far as practicable, as of the status to exist upon consummation of the plan.

3. The list or diagram shall be so prepared as to show clearly the relationship of each affiliate to the applicant and to the other affiliates

named.

4. The name of any foreign affiliate, other than a parent, may be omitted if disclosure would be detrimental to the applicant. The

Commission may, in its discretion, call for justification that such disclosure would be detrimental. The number of such affiliates

omitted pursuant to this instruction should be stated.

MANAGEMENT AND CONTROL

4. Directors and executive officers. List the names and complete mailing addresses of all directors and executive officers of the

applicant and all persons chosen to become directors or executive officers. Indicate all offices with the applicant held or to be held by

each person named.

Name

Address

Office

Instruction—Item 4. Attention is directed to the definition of the terms “director’’ and “executive officer’’ in sections 303(5) and 303(6)

of the Act.

5. Principal owners of voting securities. Furnish the following information as to each person owning 10 percent or more of the

voting securities of the applicant.

As of _______________________(Insert date within 31 days)

Col. A

Col. B

Col. C

Col. D

Name and Complete

Title of

Percentage of Voting

Mailing Address

Class Owned

Amount Owned

Securities Owned

Instructions—Item 5.

1. If the indenture securities are to be issued in connection with, or pursuant to a plan of acquisition, succession or reorganization, the

information shall also be given, so far as practicable, as of the status to exist upon consummation of the plan on the basis of present

holdings and commitments.

2. The amount to be set forth in column C as to each person named in column A shall include all securities owned by each such person

regardless of the type of ownership. For example, there shall be included (a) the amount owned of record,whether owned benefi-

cially or otherwise, and (b) the amount owned beneficially or otherwise but not of record.

UNDERWRITERS

6. Underwriters. Give the name and complete mailing address of (a) each person who within three years prior to the date of filing the

application, acted as an underwriter of any securities of the obligor which were outstanding on the date of filing the application, and (b)

each proposed principal underwriter of the securities proposed to be offered. As to each person specifed in (a), give the title of each class

of securities underwritten.

Instruction—Item 6. See Section 303(4) of the Act for the definition of the term “underwriter.’’The term “principal underwriter,’’ as used

in this item, means an underwriter in privity of contract with the issuer of the securities as to which he is an underwriter.

Sec 1919 (1-07) Form T-3 For Applications For Qualification Of Indentures Under The Trust Indenture Act Of 1939 Page 2

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