Form FR G-2 FR G-2 Deregistration Statement for Persons Registered Pursuant

FR G-2
OMB No. 7100-0011
Approval expires January 31, 2014

BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM

Designation Statement For
Persons Registered Pursuant to Regulation U
(Federal Reserve Form G-2)
A. For use by Noncorporate Registrants
This deregistration statement is required by law (15 U.S.C. 78g and 78w; 12 CFR
221).
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
15 minutes 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.

Certificate
I, (We), doing business under the name

IRS Identification No.*

hereby certify that I (we) have not, during the preceding six
calendar months, has a total of $200,000 or more of credit
outstanding secured directly or indirectly by margin stock.

outstanding at any time during a calendar quarter a total of
$500,000 or more, in credit that is secured directly or indirectly
by collateral that includes any margin stock, I (we) shall within
30 days following the end of such calendar quarter reregister
and remain registered for at least six motths with the Board
of Governors of the Federal Reserve System by filing Federal
Reserve For G-1 with the Federal Reserve Bank of the district in
which my (our) principal office is located.
This certifications is given in connection with an application for
termination of registration pursuant to Section 221.3(b)(2) of
Regulation U of the Board of Governors of the Federal Reserve
System.

I (We) understand that if I (we), in the future, extend a total
of $200,000 or more during any calendar quarter, or have

Date

Signature(s)

Print or type name(s) and title(s)

Name of firm

Telephone number (including area code)

* A registrant who is an individual is not required to disclose his or her Social Security number.

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

FR G-2
Page 2 of 2

BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM

Designation Statement For
Persons Registered Pursuant to Regulation U
(Federal Reserve Form G-2)
B. For use by Corporate Registrants
This deregistration statement is required by law (15 U.S.C. 78g and 78w; 12 CFR
221).
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
15 minutes 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.

Officer’s Certificate
I hereby certify that
Name of corporation

IRS Identification No.*

(“Corporation”) has not, during the preceding six calendar
months, has a total of $200,000 or more of credit outstanding
secured directly or indirectly by margin stock.

have outstanding at any time during a calendar quarter a total of
$500,000 or more, in credit that is secured directly or indirectly
by collateral that includes any margin stock, the Corporation
shall within 30 days following the end of such calendar quarter
reregister and remain registered for at least six motths with the
Board of Governors of the Federal Reserve System by filing
Federal Reserve For G-1 with the Federal Reserve Bank of the
district in which the principal office of the corporation is located.
This certification is given in connection with an application for
termination of registration pursuant to Section 221.3(b)(2) of
Regulation U of the Board of Governors of the Federal Reserve
System.

It is understood that if the Corporation shall, in the future, extend
a total of $200,000 or more during any calendar quarter, or

Date

Signature(s)

Print or type name(s) and title(s)

Name of firm

Telephone number (including area code)

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