Form FR G-1 FR G-1 Registration Statement for Persons Who Extend Credit Sec

FR G-1
OMB No. 7100–0011
Approval expires March 31, 2008

BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM

Registration Statement For Persons Who Extend Credit Secured by
Margin Stock (Other Than Banks, Brokers or Dealers)
(Federal Reserve Form G-1)
This registration statement is required by law (15 U.S.C. 78g and 78w; 12 CFR
221) and remains in effect until a deregistration statement is filed.
The Federal Reserve Board regards the information provided by each
respondent as confidential. If it should be determined subsequently that any
information collected on this form must be released, respondents will be
notified.
The Federal Reserve may not conduct or sponsor, and an organization (or a
person) is not required to respond to, a collection of information unless it
displays a currently valid OMB control number.

Public reporting burden for this collection of information is estimated to average
2.5 hours per response, including the time to gather and maintain data in the
required form and to review instructions and complete the information
collection. Send comments regarding this burden estimate or any other aspect
of this collection of information, including suggestions for reducing this burden
to: Secretary, Board of Governors of the Federal Reserve System, 20th and C
Streets, N.W., Washington, DC 20551; and to the Office of Management and
Budget, Paperwork Reduction Project (7100-0011), Washington, DC 20503.

Name of registrant:
IRS Identification No.*

Name under which business is conducted, if different from above:
Address of principal place of business:
(Do not use P.O. Box No.)

Street

County

City

State

ZIP Code

State

ZIP Code

Mailing address, if different from above:
Street

City

GENERAL INSTRUCTIONS

DEFINITIONS

Who must file: Section 221.3(b)(1) of Federal Reserve
Regulation U requires that FR Form G-1 be completed by
every person (other than commercial banks, brokers or
dealers) who during any calendar quarter extends a total of
$200,000 or more, or has outstanding a total of $500,000 or
more, in credit secured directly or indirectly, in whole or in
part, by collateral that includes any margin stock.

Terms used in this form are explained below. Precise
definitions may be found in Section 221.2 of Regulation U.

When and where to file: The form should be filed in duplicate
with the Federal Reserve Bank of the district in which the
principal office of subject person is located within 30 days
following the end of such quarter in which credit has been
extended or is outstanding in accordance with Section
221.3(b)(1). This registration statement will remain in effect
until a FR Form G-2 (deregistration statement) is approved by
the Board of Governors of the Federal Reserve System.
What to file: All persons subject to the registration
requirements of Section 221.3(b)(1) should (i) supply the
background information specified below; (ii) complete
Schedule A; and (iii) submit two copies of a balance sheet,
certified by an independent public accountant, for the
registrant’s latest fiscal year. If the registrant is subject to
supervision by a state or federal regulatory authority, a copy
of the latest balance sheet filed with such authority may be
used. If neither is available, the registrant should complete
Schedule B on page 4.
*A registrant who is an individual is not required to disclose his or her Social
Security number.

Registration forms will be returned to registrants for
corrections if all items have not been answered in the manner
required or if the forms are otherwise unacceptable for filing.

Person: Any individual, corporation, partnership, association,
joint stock company, business trust, or unincorporated
organization.
Purpose credit: Credit extended for the purpose of purchasing
or carrying margin stock, or to reduce or retire indebtedness
previously incurred for that purpose.
In the ordinary course of business: Occuring or reasonably
expected to occur from time to time in the course of any
activity of a person for profit or the management and
preservation of property or, in the case of a person other than
an individual, carrying out or in furtherance of any business
purpose.
Margin stock: Includes (1) stocks registered on a national
securities exchange or any OTC security designated for
trading in the National Market System, (2) debt securities that
are convertible into, or carry a warrant or right to subscribe to
or purchase margin stock, (3) any such warrant or right, and
(4) shares of most mutual funds.
Indirectly secured: In general, credit is indirectly secured by
margin stock if there is an understanding between the
borrower and the lender (1) which is designated to make the
margin stock more available to the lender in case of default
than to the borrower’s other creditors, or (2) which limits the
borrower from exercising full dominion over the margin stock
to sell, pledge, or donate them, or determining where they
shall be placed physically.

FR G-1
Page 2 of 4

Background Information
1. Principal lines of business:

2. Registrant is: (check one)
Sole proprietorship
Partnership
Corporation

Private investor
Other (specify)

a. If registrant is a sole proprietor, private investor, or other, state full residence address:

b. If registrant is a corporation, state date and place of incorporation:
  Date:

Place:

c. Person responsible for maintaining records in connection with Regulation U:
  Name:

Title:

  Telephone Number (include area code):
3. If any of the accounts or records of registrant are kept or maintained by anyone other than the person named in 2(c), furnish
the name and address of the other individual, firm, or organization:

4. a. Does any person not named in items 2(c) or 3 above exercise or have power to exercise a controlling influence over the
   management or policies of registrant, directly or indirectly, through stock ownership, agreement, or otherwise?
Yes

No

b. If “yes”, state the name of such person and describe the agreement, arrangement, or nature of the controlling influence:

5. a. Does the registrant extend credit in connection with an employee stock option or stock purchase plan pursuant to the
   special “plan-lender” provision set forth in Section 221.4(a) of Regulation U? If so, submit two copies of documents
   establishing the plan, a prospectus, and other information which supports adherence to plan-lender limitations.
Yes

No

5. b. Does the registrant extend credit to an employee stock ownership plan (ESOP) qualified under section 401 of the Internal
   Revenue Code (26 U.S.C. 401), as set forth in Section 221.4(c) of Regulation U? If so, submit two copies of documents
   establishing the plan and any other pertinent supporting information.
Yes

No

FR G-1
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Schedule A—Securities Credit
As of

,
I¹
Total credit outstanding
at end of quarter
(dollars)
Mil

Thou

Dollars

II²
Credit extended
during quarter
(dollars)
Mil

Thou

Dollars

A. Credit to purchase or carry margin stock (Purpose Loans):
1. Secured directly by margin stock:
   a. Listed stocks and OTC margin stocks ...........................................
   b. Debt securities convertible into margin stock .................................
   c. Mutual funds and other margin stock ...........................................
2. Secured indirectly by margin stock ...................................................
3. TOTAL (Purpose Credit) ..................................................................

B. Other credit (Nonpurpose Loans):
1. Secured directly by margin stock:
   a. Listed stocks and OTC margin stocks ...........................................
   b. Debt securities convertible into margin stock .................................
   c. Mutual funds and other margin stock ...........................................
2. Secured indirectly by margin stock ....................................................
3. TOTAL (Nonpurpose Credit) .............................................................

1. “Credit outstanding” (Column I) includes credit extended by the registrant during the quarter covered by this report, and during previous quarters, that has not
been extinguished before the end of the quarter covered by this report.
2. “Credit extended” (Column II) is credit extended by the registrant at any time during the quarter covered by this report. Column II includes new credit extended
during the quarter regardless of whether such credit was extinguished at the end of the quarter. An increase in an existing loan is new credit.

FR G-1
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Schedule B—Balance Sheet
As of

,

This schedule is to be completed only by lenders not submitting corporate balance sheets certified by an independent public
accountant or used to meet reporting requirements of a state or federal regulatory authority.

($ Thousands)
ASSETS

LIABILITIES AND NET WORTH

Cash and bank deposits

Short-term bank borrowings

Trade accounts and notes receivable
(net allowance for bad debts of
)

Other notes and accounts payable

Other accounts and notes receivable
(include credit to executives and
employees)

All other liabilities

Marketable securities

Capital stock

Inventories

Additional paid-in capital

Investments in non-consolidated
subsidiaries

Retained earnings/undivided profits

Long-term debt

TOTAL LIABILITIES

Total Equity Capital¹
Fixed assets (net of depreciation)
All other assets
TOTAL LIABILITIES AND
EQUITY CAPITAL

TOTAL ASSETS

1. Registrants not reporting capital stock, additional paid-in-capital or retained earnings/undivided profits must nevertheless indicate total equity capital.

Certification
The registrant filing this registration form and any attachments thereto and the person by whom it is executed represent hereby
that all information contained therein is true and complete.

Date

Signature of sole proprietor, general partner, managing agent, or principal officer

Telephone number (including area code)

Print or type name

Title

This mandatory report is needed to elicit certain background and financial information about a Regulation U lender and the types
and amount of credit activities engaged in that are secured by margin stock.

Honest, accurate, and timely statements are required by law.
(15 U.S.C. §78ff; 18 U.S.C. §1001)