United States Securities and Exchange Commission
Washington, DC 20549
FORM 13H
Information Required Regarding Large Traders Pursuant To Section 13(h) of the
Securities Exchange Act of 1934 and Rules Thereunder
[ ] INITIAL FILING: Date identifying transactions first effected (mm/dd/yyyy)________________________
[ ] ANNUAL FILING: Calendar year ending _________
Items and schedules being updated________________________________________
[ ] INTERIM FILING: Items and schedules being corrected________________________________________
Effective date of each correction___________________________________________
[ ] INACTIVE STATUS: Date commencing inactive status (mm/dd/yyyy)____________________________
[ ] TERMINATION FILING: Effective date (mm/dd/yyyy)________________________________________
[ ] REACTIVATED STATUS: Date identifying transactions first effected, post-inactive status
(mm/dd/yyyy)_______________________________________________________
_________________________________________________________________________________________
Name of Large Trader
_____________________________________ __________________________________________________
LTID Taxpayer Identification Number
________________________________________________________________________________________
Business Address (Street, City, State, Zip)
Telephone No. (___) ___ - ____ Facsimile No. (___) ___ - ____ Email _____________________________
The Form, schedules, and continuation sheets must be submitted by a natural person who either is the large trader or is a person authorized by the large trader to make this submission. If this authorized person is anyone other than the large trader named above, complete the item immediately below:
________________________________________________________________________________________
Name and Title of Authorized Person (Last, First, Middle Initial)
________________________________________________________________________________________
Relationship to Large Trader
________________________________________________________________________________________
Business Address (Street, City, State, Zip)
Telephone No. (___) ___ - ____ Facsimile No. (___) ___ - ____ Email _____________________________
ATTENTION
Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Intentional misstatements or omissions of facts may result in civil fines and other sanctions pursuant to the Securities Exchange Act of 1934.
The authorized person signing this form represents that all information contained in the form, schedules, and continuation sheets is true, correct, and complete. It is understood that all information whether contained in the form, schedules, or continuation sheets, is considered an integral part of this form and that any amendment represents that all unamended information remains true, correct, and complete.
Pursuant to the Securities Exchange Act of 1934, the undersigned has caused this form to be signed on its behalf in the city of ___________________ and the State of _______________ on the _______ day of _________, 2____.
___________________________________________
Signature of Person Authorized to Submit this Form
FORM 13H
INFORMATION REQUIRED OF ALL LARGE TRADERS
ITEM 1. BUSINESSES OF THE LARGE TRADER (check as many as applicable)
[ ] Broker or Dealer [ ] Pension Trustee
[ ] Investment Adviser [ ] Holding Company
[ ] Insurance Company [ ] Government Securities Broker or Dealer
[ ] Other Financial Institution [ ] Municipal Securities Broker or Dealer
[ ] Commodity Pool Operator [ ] Futures Commission Merchant
[ ] Bank [ ] Other (specify) ________________
[ ] Investment Company registered under [ ] Hedge Fund or other Fund not registered under
the Investment Company Act the Investment Company Act
ITEM 2. SECURITIES AND EXCHANGE COMMISSION REGISTRATION
Does the large trader, or any of its affiliates, file any forms with the Commission?
[ ] Yes [ ] No
If yes, specify the forms filed:
-- Use Continuation Sheets if Necessary --
Entity Form(s) Filed SEC File No. or CRD Number
(if applicable)
_________________________________ ______________ _________________________
_________________________________ ______________ _________________________
_________________________________ ______________ _________________________
_________________________________ ______________ _________________________
ITEM 3. REGULATED ENTITIES
(a) Is the large trader or any of its affiliates registered with the CFTC as a “registered trader” pursuant to sections 4i and 9 of the Commodity Exchange Act?
[ ] Yes [ ] No
If yes, specify the registration number: ___________________________
Is the large trader or any of its affiliates otherwise registered under the Commodity Exchange Act?
[ ] Yes [ ] No
If yes, specify the type of registration and number:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
-- Use Continuation Sheets if Necessary --
(b) Is the large trader or any of its affiliates a bank holding company, national bank, state member bank of the Federal Reserve System, state non-member bank, savings bank or association, credit union, or foreign bank?
[ ] Yes [ ] No
If yes, identify each entity and its bank regulator:
_______________________________ __________________________________
_______________________________ __________________________________
(c) Is the large trader or any of its affiliates an insurance company?
[ ] Yes [ ] No
If yes, identify each entity and its insurance regulator:
_______________________________ __________________________________
_______________________________ __________________________________
(d) Is the large trader or any of its affiliates regulated by a foreign regulator?
[ ] Yes [ ] No
If yes, identify each entity and its foreign regulator(s):
_______________________________ __________________________________
_______________________________ __________________________________
ITEM 4. ORGANIZATION/INDIVIDUAL INFORMATION
Complete and submit Schedule 4 with this Form.
ITEM 5. LARGE TRADER AFFILIATES
Does the large trader have any affiliates that either exercise investment discretion over accounts that hold NMS securities or that beneficially own NMS securities?
[ ] Yes [ ] No
If yes, identify each affiliate and its relationship to the large trader below.
-- Use Continuation Sheets if Necessary --
Name Business Relationship to the Large Trader LTID (if any)
________________________ _____________ ________________________________ ___________
________________________ _____________ ________________________________ ___________
________________________ _____________ ________________________________ ___________
ITEM 6. LIST OF ACCOUNTS OVER WHICH THE LARGE TRADER EXERCISES INVESTMENT
DISCRETION
Complete and submit Schedule 6 with this Form.
SCHEDULE 4 TO FORM 13H
Page ___ of ___ Name of Large Trader _______________________________ LTID ___________
ITEM 1. LARGE TRADER ORGANIZATION (check as many as apply)
[ ] Self-Employed (for individuals) [ ] Partnership
[ ] Otherwise Employed (for individuals) [ ] Limited Partnership
[ ] Trustee [ ] Corporation
[ ] Limited Liability Company [ ] Other ________________________
Complete the following for each general partner, and in the case of limited partnerships, each limited partner that is the owner of more than a 10 percent financial interest in the accounts of the large trader:
-- Use Continuation Sheets if Necessary --
Name Status (check one for each)
________________________________ [ ] General Partner [ ] Limited Partner
________________________________ [ ] General Partner [ ] Limited Partner
________________________________ [ ] General Partner [ ] Limited Partner
________________________________ [ ] General Partner [ ] Limited Partner
________________________________ [ ] General Partner [ ] Limited Partner
________________________________ [ ] General Partner [ ] Limited Partner
________________________________ [ ] General Partner [ ] Limited Partner
Complete the following for each executive officer, director, or trustee of a large trader corporation or trustee:
-- Use Continuation Sheets if Necessary --
Name Status (check one for each)
___________________________________ [ ] Officer [ ] Director [ ] Trustee
___________________________________ [ ] Officer [ ] Director [ ] Trustee
___________________________________ [ ] Officer [ ] Director [ ] Trustee
___________________________________ [ ] Officer [ ] Director [ ] Trustee
___________________________________ [ ] Officer [ ] Director [ ] Trustee
___________________________________ [ ] Officer [ ] Director [ ] Trustee
___________________________________ [ ] Officer [ ] Director [ ] Trustee
ITEM 2. JURISDICTION IN WHICH THE LARGE TRADER ENTITY IS INCORPORATED OR ORGANIZED:
________________________________________________________________________________
(city, state)
ITEM 3. PRINCIPAL PLACE OF BUSINESS, IF DIFFERENT THAN INFORMATION
PROVIDED ON THE COVER PAGE:
________________________________________________________________________________
(street, city, state, zip)
ITEM 4. DESCRIBE THE NATURE OF THE LARGE TRADER ENTITY’S BUSINESS
________________________________________________________________________________
SCHEDULE 6 TO FORM 13H
LIST OF ACCOUNTS OVER WHICH THE LARGE TRADER EXERCISES INVESTMENT DISCRETION
Page ___ of ___ Name of Large Trader _______________________________ LTID ____________
ITEM 1. DESIGNATE THE PERSON(S) TO CONTACT FOR INFORMATION REGARDING
TRANSACTIONS EFFECTED THROUGH THE ACCOUNTS LISTED ON THIS SCHEDULE:
-- Use Continuation Sheets if Necessary --
___________________________________________________________
Name and Title of Designated Person
___________________________________________________________
Business Address (street, city, state, zip)
Telephone No. (___) ___ - ____ Facsimile No. (___) ___ - ____ Email___________________
ITEM 2. IDENTIFICATION OF ACCOUNTS
-- Use Continuation Sheets if Necessary --
LTIDs of Other Large Traders
Broker-Dealer Account That Exercise Investment
Broker-Dealer Account Number Name Discretion Over the Account
_________________ __________________ ______________ _____________________________
_________________ __________________ ______________ _____________________________
_________________ __________________ ______________ _____________________________
_________________ __________________ ______________ _____________________________
_________________ __________________ ______________ _____________________________
_________________ __________________ ______________ _____________________________
_________________ __________________ ______________ _____________________________
Large traders are required to disclose their LTID to their executing broker-dealers, including those listed on this schedule if applicable, and to comply with the identification requirements of Rule 13h-1.
INSTRUCTIONS FOR FORM 13H
A. Instructions for Form 13H—Cover Page.
Type
of Filing. Indicate the type of Form 13H filing by checking the
appropriate box at the top of the cover page to Form 13H.
If
the filing is an “Initial Filing,” indicate the first
date on which the aggregate number of transactions effected reached
the identifying activity level. An initial filing must include a
manually signed Form 13H and all applicable Schedules.
If
the filing is an “Annual Filing,” indicate the ending
date of the applicable calendar year and list the specific Items or
Schedules that are amended or changed. If no information has
changed, the large trader need only complete and sign the cover
pages.
If the filing is an “Interim Filing”
indicate the Items and Schedules being corrected and the effective
date(s) of the corrections. “Interim Filings” must be
filed promptly following the end of a calendar quarter in the event
that any of the information contained in a Form 13H filing becomes
inaccurate for any reason. A large trader must file an “Interim
Filing,” when, for example, it changes its name, business
address, organization type (e.g., a large trader partnership
reincorporates as a limited liability company, or regulatory status
(e.g., a hedge fund registers under the Investment Company
Act), or when it adds or closes brokerage accounts through which it
trades. A large trader also must file an “Interim Filing”
to reflect changes in affiliations (e.g., the large trader
acquires or is acquired by another entity, an existing affiliate
becomes a large trader) and joint account management (e.g., a
large trader assumes sole management authority over an account that
formerly was jointly managed with another large trader).
If the filing is for “Inactive Status,” indicate the date that the large trader qualified for inactive status. A large trader shall become inactive, and exempt from the filing and self-identification requirements upon filing for inactive status until the identifying activity level is reached again.
If the filing is for “Reactivated Status,” indicate the date that the aggregate number of transactions again reached or exceeded the identifying activity level.
All filings, other than the “Initial
Filing,” must indicate the applicable LTID assigned by the
Commission and the Taxpayer Identification Number of the large
trader. A large trader of inactive status that subsequently resumes
activities requiring it to file Form 13H will retain the LTID
initially assigned by the Commission and must include that LTID in
its filing for “Reactivated Status.”
B. Instructions for Form 13H—Items
1 through 5.
Item 1. Business of the Large Trader. Specify
the type of business engaged in by the large trader by checking one
or more of the listed business types. If the large trader is engaged
in more than one type of business, check each type that applies to
the large trader. If the large trader is an individual, check
“Other” and specify the occupation of such individual.
Large trader trust companies and thrift institutions must check
“Other Financial Institution.” The large trader must
disclose in Item 1 only those businesses in which it is directly
engaged; businesses engaged in by affiliates of the large trader must
be disclosed in Item 5.
Item 2. SEC Registrations.
Indicate whether the large trader or any of its affiliates files
forms with the Commission. If “Yes” is checked, identify
the entity and the applicable form(s) filed.
SEC file numbers may be obtained
through EDGAR, and CRD numbers may be obtained by calling the member
services office of the Financial Industry Regulatory Authority
(FINRA), during normal business hours.
Item 3. Regulated Entities.
Indicate whether the large trader or any of
its affiliates is registered with the Commodity Futures Trading
Commission as a “Reporting Trader” pursuant to Sections
4i and 9 of the Commodity Exchange Act, or otherwise is registered
under the Commodity Exchange Act. If so, for each entity, specify
the number and type of registration. Indicate whether the large
trader or any of its affiliates is a bank holding company, national
bank, state member bank of the Federal Reserve System, state
non-member bank, savings bank or association, credit union, or
foreign bank. If so, for each entity, identify the bank regulator.
Indicate whether the large trader or any of its affiliates is an
insurance company and, if so, identify each entity and its insurance
regulator. Indicate whether the large trader or any of its
affiliates is regulated by a foreign regulator. If so, for each
entity, identify the foreign regulator(s). Unlike Item 1, Item 3
applies to the large trader and its affiliates.
Item 4 and
Schedule 4. Type of Large Trader.
The large trader must fill out Schedule 4, which captures basic organizational information. The term “executive officer,” used in Schedule 4, means “policy-making officer” and otherwise is interpreted in accordance with Rule 16a-1(f) under the Exchange Act. If the entity is incorporated in more than one jurisdiction, all jurisdictions must be identified. All terms, including “limited liability company,” have the meanings ascribed to them in the United States.
Item 5. Large Trader Affiliates.
Indicate in Item 5a whether the large trader has any affiliates that either exercise investment discretion over accounts that hold or beneficially own NMS securities. For purposes of the Form, an “affiliate” is any person that, directly or indirectly, controls, is under common control with, or is controlled by the large trader. If “Yes” is checked, identify all affiliates, and describe their businesses and relationships to the large trader (e.g., direct subsidiary, general partner in Limited Partnership A). Disclose in Item 5b names and LTIDs of affiliated large traders (if any).
Item 6 and Schedule 6. List of Large
Trader Accounts.
All large traders must fill out Schedule 6, which requires a large trader to list information about the accounts over which the large trader exercises investment discretion. Provide the following information: the name of the registered broker-dealer that holds the account, the account number, the account name, and, if another large trader also exercises investment discretion over an account, the LTID of that other large trader. Large traders may attach internally produced lists of accounts to the Schedule provided that such lists capture all required information in a format substantially similar to the Schedule. If the large trader does not know the LTID of the other large traders at the time of filing (e.g., when it files its “Initial Filing”), it must submit promptly an “Interim Filing” upon learning those LTIDs. Provide also name(s) and contact information for the person(s) designated to provide information about the transactions effected through these accounts.
Qualifications of the Designated
Contact Person. The large trader is required to designate a contact
person for information regarding the accounts listed on the Schedule.
The designated contact person must: (i) be a natural person; (ii)
be employed by or otherwise affiliated with the large trader; (iii)
be authorized by the large trader to respond promptly to any
inquiries or requests from the Commission.
Requests for
Information. The Commission may require the large trader to provide
descriptive or clarifying information about the information disclosed
in the Form 13H.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | rubing |
File Modified | 0000-00-00 |
File Created | 2021-02-02 |