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

FR G-1
OMB No. 7100-0011
Approval expires January 31, 2014

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 or No.)

Street

City

County

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, principally (1) stocks that are registered
on a national securities exchange or any over-the-counter
security designated for trading in the National Market System,
(2) debt securities (bonds) that are convertible into margin stock,
and (3) shares of most mutual funds.
Indirectly secured: In general, credit is indirectly secured by
margin stock if there is any 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 form
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 coporation, 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 indirecly, 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

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):
b

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 .........................................................
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 1) 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 the 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 scheule 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 pain-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.
Signature of sole proprietor, general partner, managing agent, or principal officer
Date
Print or type name
Telephone number (including area code)
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)