SEC 2084 (5/93) Previous form obsolete |
Persons who potentially are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. |
Applicant's CIK (if known) |
OMB APPROVAL |
OMB Number: 325-0328 |
Expires: May 31, 2001 |
Estimated average burden hours per response: . .0.15 |
[ ] | Initial Application | [ ] | Amendment |
City | State | Zip |
Filer | Filing Agent | Training Agent |
Initial Application for EDGAR Access Codes. |
CCC | Password | PMAC |
1933 Act No. | 1934 Act No. | 1935 Act No. | 1940 Act No. | Other | ||||||||||
2 | - | __________ | 0 | - | __________ | 70 | - | __________ | 811 | - | __________ | ____ | - | __________ |
33 | - | __________ | 1 | - | __________ | 69 | - | __________ | 814 | - | __________ | |||
333 | - | __________ | 28 | - | __________ |
Registrant's
Tax Number or Federal Identification Number |
Telephone
Number (Include Area Code) |
City | State | Zip |
State of Incorporation/Organization | Fiscal Year End (mm/dd) |
City | State | Zip |
Person to receive SEC Account Information and Billing Invoices | Telephone Number (Include Area
Code) ( ) |
City | State | Zip |
Signature: |
Type or Print
Name: |
Position or
Title: |
Date: |
- Central Index Key (CIK) - The CIK uniquely identifies each filer, filing agent, and training agent. We assign the CIK at the time you make an initial application. You may not change this code.
- CIK Confirmation Code (CCC) - You will use the CCC in the header of your filings in conjunction with your CIK to ensure that you authorized the filing.
- Password (PW) - The PW allows you to log onto the EDGAR system, submit filings, and change your CCC.
- Password Modification Authorization Code (PMAC) - The PMAC allows you to change your password.
Please see the EDGAR Filer Manual for instructions on how to file electronically, including how to use the access codes.
You must complete all items in any parts which apply to you. If any item in any part does not apply to you, please mark that part "NA." If your form is incomplete, it may take us longer to assign your access codes.
Please check the appropriate box to indicate whether you will be sending electronic submissions as a filer, filing agent, or training agent. Mark only one of these boxes per application. A "filer" is any person or entity on whose behalf an electronic filing is made. A "filing agent" is a financial printer, law firm, or other party which will be using these access codes to send a filing or portion of a filing on behalf of a filer. A "training agent" is any person or entity which will be sending only test filings in conjunction with training other persons.
If you do not already have access codes, please mark the "Initial application" box, and complete all other items in Parts II through V that apply to you.
If you already have access codes, please provide your CIK in the upper left corner, and mark the boxes to indicate the reason you are filing the amendment and any access codes you want to replace. You also should complete Part V (signature) and those items in Parts II through IV which have changed from the previous application. You may change your access codes (except your PMAC) and most other information on Form ID electronically via EDGAR. See the EDGAR Filer Manual for details.
The registrant's tax or federal identification number is the number issued by the Internal Revenue Service. Foreign private issuers should include all zeroes if they do not have a tax or federal identification number. (We do not require this number for individuals.)
We do not require state of incorporation/organization or fiscal year end for individuals. We request that foreign private issuers include their country of organization.
In this section, identify the individual who should receive the access codes and EDGAR-related information.
If you are or become an EDGAR Private Mail subscriber, you can receive acceptance and suspension messages and any requested return copies of your filings via electronic mail at your expense. If you do not subscribe to EDGAR Private Mail, you can receive your acceptance and suspension messages via Internet E-Mail if you provide an address. We will not send return copies of filings to an Internet address.
Identify in this section the individual who should receive account information and/or billing invoices from us. We will use this information to electronically process fee payments and billings.
Send your manually signed and dated form to:
Branch of Filer Support U.S. Securities and Exchange Commission Operations Center, Stop 0-7 6432 General Green Way Alexandria, VA 22312 |
http://www.sec.gov/smbus/forms/id.htm
Last update: 10/22/1999