Securities and Exchange Commission, Washington, D.C. 20549
Schedule 13G
Under the Securities Exchange Act of 1934
(Amendment No.__)*
_______________________________
(Name of Issuer)
_______________________________
(Title of Class of Securities)
_______________________________
(CUSIP Number)
_______________________________
(Date of Event Which Requires Filing of this Statement)
Check the appropriate box to designate the rule pursuant to which this Schedule is filed:
[ ] Rule 13d-1(b)
[ ] Rule 13d-1(c)
[ ] Rule 13d-1(d)
* The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.
The information required in the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).
CUSIP No.______ | |
(1) Names of reporting persons | |
(2) Check the appropriate box if a member of a group | (a) |
(see instructions) | (b) |
(3) SEC use only | |
(4) Citizenship or place of organization | |
Number of shares beneficially owned by each reporting person with: | |
(5) Sole voting power | |
(6) Shared voting power | |
(7) Sole dispositive power | |
(8) Shared dispositive power | |
(9) Aggregate amount beneficially owned by each reporting person | |
(10) Check if the aggregate amount in Row (9) excludes certain shares (see instructions) | |
(11) Percent of class represented by amount in Row (9) | |
(12) Type of reporting person (see instructions) |
Page __ of __ Pages
Instructions for Cover Page:
Category | Symbol |
Broker Dealer | BD |
Bank | BK |
Insurance Company | IC |
Investment Company | IV |
Investment Adviser | IA |
Employee Benefit Plan or Endowment Fund | EP |
Parent Holding Company/Control Person | HC |
Savings Association | SA |
Church Plan | CP |
Corporation | CO |
Partnership | PN |
Individual | IN |
Non-U.S. Institution | FI |
Other | OO |
Notes: Attach as many copies of the second part of the cover page as are needed, one reporting person per page.
Filing persons may, in order to avoid unnecessary duplication, answer items on the schedules (Schedule 13D, 13G or TO) by appropriate cross references to an item or items on the cover page(s). This approach may only be used where the cover page item or items provide all the disclosure required by the schedule item. Moreover, such a use of a cover page item will result in the item becoming a part of the schedule and accordingly being considered as "filed" for purposes of section 18 of the Securities Exchange Act or otherwise subject to the liabilities of that section of the Act.
Reporting persons may comply with their cover page filing requirements by filing either completed copies of the blank forms available from the Commission, printed or typed facsimiles, or computer printed facsimiles, provided the documents filed have identical formats to the forms prescribed in the Commission's regulations and meet existing Securities Exchange Act rules as to such matters as clarity and size (Securities Exchange Act Rule 12b-12).
Special Instructions for Complying With Schedule 13G
Under Sections 13(d), 13(g) and 23 of the Securities Exchange Act of 1934 and the rules and regulations thereunder, the Commission is authorized to solicit the information required to be supplied by this schedule by certain security holders of certain issuers.
Disclosure of the information specified in this schedule is mandatory. The information will be used for the primary purpose of determining and disclosing the holdings of certain beneficial owners of certain equity securities. This statement will be made a matter of public record. Therefore, any information given will be available for inspection by any member of the public.
Because of the public nature of the information, the Commission can use it for a variety of purposes, including referral to other governmental authorities or securities self-regulatory organizations for investigatory purposes or in connection with litigation involving the Federal securities laws or other civil, criminal or regulatory statutes or provisions.
Failure to disclose the information requested by this schedule may result in civil or criminal action against the persons involved for violation of the Federal securities laws and rules promulgated thereunder.
Instructions.
2(a) Name of person filing:
_______________________________
2(b) Address or principal business office or, if none, residence:
_______________________________
2(c) Citizenship:
_______________________________
2(d) Title of class of securities:
_______________________________
2(e) CUSIP No.:
_______________________________
Provide the following information regarding the aggregate number and percentage of the class of securities of the issuer identified in Item 1.
Instruction. For computations regarding securities which represent a right to acquire an underlying security see§ 240.13d-3(d)(1) .
Instruction. Dissolution of a group requires a response to this item.
If a group has filed this schedule pursuant to § 240.13d-1(b)(1)(ii)(K) , so indicate under Item 3(k) and attach an exhibit stating the identity and Item 3 classification of each member of the group. If a group has filed this schedule pursuant to Rule 13d-1(c) or Rule 13d-1(d), attach an exhibit stating the identity of each member of the group.
By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were acquired and are held in the ordinary course of business and were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant in any transaction having that purpose or effect, other than activities solely in connection with a nomination under § 240.14a-11 .
By signing below I certify that, to the best of my knowledge and belief, the foreign regulatory scheme applicable to [insert particular category of institutional investor] is substantially comparable to the regulatory scheme applicable to the functionally equivalent U.S. institution(s). I also undertake to furnish to the Commission staff, upon request, information that would otherwise be disclosed in a Schedule 13D.
By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant in any transaction having that purpose or effect, other than activities solely in connection with a nomination under § 240.14a-11 .
Signature. After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.
Dated:____
__________.
Signature.
__________.
Name/Title.
The original statement shall be signed by each person on whose behalf the statement is filed or such person's authorized representative. If the statement is signed on behalf of a person by such person's authorized representative other than an executive officer or general partner of the filing person, evidence of the representative's authority to sign on behalf of such person shall be filed with the statement; provided, however, that a power of attorney for this purpose which is already on file with the Commission may be incorporated by reference. The name and any title of each person who signs the statement shall be typed or printed beneath such person's signature.
Note: Schedules filed in paper format shall include a signed original and five copies of the schedule, including all exhibits. See Rule 13d-7 for other parties for whom copies are to be sent.
17 C.F.R. §240.13d-102