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Application for EDGAR Access
ICR 202610-3235-014 · OMB 3235-0328 · Object 173904600.
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| File Type | application/pdf |
|---|---|
| File Title | Application for EDGAR Access |
| Last Modified By | PDFium |
| File Created | 2025-01-23 |
| Conversion State | complete |
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APPENDIX A—FORM ID FORM ID APPLICATION FOR EDGAR ACCESS Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a current valid OMB control number. IMPORTANT INFORMATION Complete Form ID by reference to: • • • Rules 10 and 11 of Regulation S-T, 17 CFR 232.10 and 232.11; The requirements set forth in of Volume I of the EDGAR Filer Manual; and The Form ID General Instructions on this interface. On Form ID, the applicant must authorize two (2) individuals as account administrators; except an applicant that is an individual or single-member company must authorize one (1) individual as account administrator. • • The first account administrator listed on Form ID will be considered the applicant’s EDGAR point of contact (“EDGAR POC”) should the Form ID application be granted. SEC staff will attempt to contact the EDGAR POC first but may contact other account administrators if the EDGAR POC is not available. Information submitted on Form ID may become public. • • Do not enter personal contact information on Form ID that you do not wish to become public. Your Form ID application may be rejected if you submit unsolicited sensitive personally identifiable information on the form or in any attachments. Misstatements or omissions of fact in connection with an application for EDGAR access and/or in a submission on EDGAR may constitute a criminal violation under 18 U.S.C. 1001 and 1030 and/or a violation of other criminal and civil laws. If the SEC has reason to believe that an application for EDGAR access and/or a submission on EDGAR is misleading, manipulative, and/or unauthorized, the SEC may prevent acceptance or dissemination of the application/submission and/or prevent future submissions or otherwise remove a filer’s access to EDGAR pursuant to Rule 15 of Regulation S-T, 17 CFR 232.15. If your Form ID application is granted, be aware that EDGAR filers must comply with the rules and regulations governing access to the EDGAR system set forth in Regulation S-T and the EDGAR Filer Manual, including but not limited to the following: 194 • • • Filers must only provide access to EDGAR to persons or entities authorized by the filer to take action on behalf of the filer. Immediately upon determining that a person or entity is no longer authorized to take action on the filer’s behalf, filers must remove the EDGAR access of that person or entity. Filers must inform the SEC immediately upon receiving information of any unauthorized activity in the filer’s EDGAR account. Filers should contact EDGAR Filer Support at (202) 551-8900. Privacy Act Statement AUTHORITIES: The information is sought pursuant to 15 U.S.C. 77a et seq., 15 U.S.C. 77aaa et seq., 78a et seq., 80a-1 et seq., and 17 CFR 232.10. PURPOSE: The information solicited on this form will be used to determine whether to allow applicants to make filings on EDGAR, and, where access is granted, to establish and maintain the filer's EDGAR account ROUTINE USES: Uses for the information collected can be found in the System of Records Notice SEC-33: General Information Technology Records. See https://www.sec.gov/about/privacy/sorn/sec33_sec_general_information_technology_records.pdf. DISCLOSURE: Providing this information is voluntary. Failure to provide the information requested on this form, however, may affect the determination whether to allow applicants to make filings on EDGAR. PART 1 – APPLICATION FOR EDGAR ACCESS (To be completed by all applicants) Is this application for a new EDGAR account or for access to an existing EDGAR account? □ New EDGAR account (new EDGAR account number, known as a Central Index Key (CIK), will be issued) □ Existing EDGAR account (applicant currently has an EDGAR account and Central Index Key (CIK)) Enter existing CIK account number __________________________________________________ Indicate the reason the applicant is seeking access to an existing EDGAR account. □ Broker-dealer or “paper filer” seeks electronic access for the first time in order to file electronically on EDGAR □ Filer lost electronic access to its existing CIK account 195 □ Applicant is the legal successor of the filer named on the existing CIK account but did not receive access from that filer Applicant information Is the applicant a company or an individual? Only apply as an individual if you seek an EDGAR account for yourself as a natural person. All others should apply as a company. □ Applicant is a company Enter company’s full legal name: __________________________ Conformed name___________________________ (the name that will appear on public EDGAR) □ Applicant is an individual Enter individual’s full legal name, including middle name: First name___________________________________________________________ Middle name _________________________________________________________ □ No middle name Last name ____________________________________________________________ Suffix _______________________________________________________________ Conformed name_______________________________________________________ Applicant type Select one (1) most relevant applicant type. Select “Filer” if none of the other applicant types listed below apply. □ Filer □ Filing Agent The “filing agent” applicant type should be selected ONLY if the applicant is engaged in the business of making submissions to EDGAR on behalf of filers and does not intend to make live filings on its own behalf on EDGAR. A filing agent that wishes to make live filings on its own behalf should select the “filer” applicant type. □ Funding Portal □ Institutional Investment Manager (Form 13F Filer) □ Investment Company, Business Development Company or Insurance Company Separate Account □ Large Trader □ Municipal Advisor □ Nationally Recognized Statistical Rating Organization □ Non-Investment Company Applicant under the Investment Company Act of 1940 □ Security-Based Swap Data Repository □ Security-Based Swap Dealer and Major Security-Based Swap Participant □ Security-Based Swap Execution Facility 196 □ Transfer Agent A “transfer agent” CIK may only be used for submitting transfer agent filings on EDGAR. □ Training Agent A “training agent” CIK may only be used for submitting test filings on EDGAR. This applicant type is typically selected by a filing agent or third-party EDGAR software provider that needs a dedicated EDGAR CIK for testing their script or software configuration interface with EDGAR. ONLY FOR NON-PUBLIC DRAFT REGISTRATION/OFFERING STATEMENTS (DRS/DOS) If a company is applying for EDGAR access to submit non-public draft registration/offering statements on submission types DRS or DOS, select Yes. □ Yes Selecting “Yes” will prevent the new CIK number and EDGAR account information from being made publicly available on SEC.gov until a public filing is made. This option is only available for companies who plan to submit submission types DRS or DOS. Applicant’s mailing address and preferred contact information The applicant may list its own information, or information for its registered agent, law firm, or filing agent (collectively, “third-party service provider”) in this section. □ Address is for a non-U.S. location (do not select if address is for U.S. territory) Street address (line 1) ______________________ Street address (line 2) (optional) ___________________________ City_________________________________ State/U.S. Territory __________________________ Zip/Postal code (optional for non-U.S. locations)_____________________________ Province/Country _____________________________ Telephone number (optional)_____________________ Violations of Federal or state securities laws Has the applicant (company or individual) been criminally convicted as a result of a Federal or state securities law violation, or civilly or administratively enjoined, barred, suspended, or banned in any capacity (e.g., officer or director bar, prohibition from associating with brokers, dealers, investment advisers, and/or other securities entities, or bar from participation in certain industries), as a result of a Federal or state securities law violation? □ Yes □ No If you indicate “Yes,” the SEC staff may contact you to determine your eligibility for EDGAR access. 197 PART 2 – COMPANY APPLICANT INFORMATION (To be completed only by applicants who are not natural persons) Company business information Company's Tax or Federal Identification Number (do not enter Social Security Number) ________ Legal Entity Identifier (LEI), if any _____________ Legal name _________________ Doing business as name, if different from legal name ______________________ U.S. state of incorporation ________ If foreign issuer, country of incorporation _____________ Foreign issuer name, if different than English name used in U.S. _________________ (enter only English characters) Fiscal year end (mm/dd) _________________________ Company’s primary website, if any ___________________ Is the company in good standing in its state or country of incorporation? Generally, this means a company is legally authorized to do business in that state or country and has filed all required reports and paid all related fees to the relevant jurisdiction. □ Yes □ No Company’s primary business information This must be the applicant company’s primary business information, or that of the company’s registered agent. Do not enter the address of the company’s law firm or filing agent. You must enter the actual physical address; P.O. boxes are not acceptable. □ Primary business information is the same as the mailing address and preferred contact information in Part 1. If this box is selected, the relevant information will be added below. □ Address is for a non-U.S. location (do not select if address is for U.S. territory) Street address (line 1) ______________________ Street address (line 2) (optional) _____________________________ City _________________________________________ State/U.S. Territory __________________________________ Zip/Postal code (optional for non-U.S. locations) ______________________________________ Province/Country ______________________________________ Telephone number ______________________________ 198 Single-Member Company? You should select “Yes” if the company only has a single individual who acts as the sole equity holder, director, and officer (or, in the case of an entity without directors and officers, holds position(s) performing similar activities as a director and officer). □ Yes □ No PART 3 – PROSPECTIVE ACCOUNT ADMINISTRATOR INFORMATION (To be completed by all applicants) Account administrators are individuals authorized by the applicant to manage the applicant’s EDGAR account on EDGAR should the Form ID application be granted. Prospective Account Administrator 1 The first account administrator listed on Form ID will be considered the applicant’s EDGAR point of contact (“EDGAR POC”) if the Form ID application is granted. SEC staff will attempt to contact the EDGAR POC first but may contact other account administrators if the EDGAR POC is not available. Enter full legal name, including middle name First name _____________________________ Middle name ____________________________ □ No middle name Last name ______________________________ Suffix _________________________________ Business title/position ____________________ Is Prospective Account Administrator 1 the applicant (for an individual applicant), or an employee of the applicant or its affiliate (for a company applicant)? □ Yes □ No Provide the full legal name of the prospective account administrator’s employer and the employer’s CIK, if any. In addition, you must attach to your submission a notarized power of attorney authorizing the individual as an account administrator to manage the applicant’s EDGAR account, as set forth more fully in Part 6 of this form. Employer (full legal name) _______________________________________ CIK of employer (if any) ___________________ Business address and contact information □ Contact information is the same as the mailing address and preferred contact information in Part 1. If this option is selected, the relevant information will be added below. 199 □ Contact information is the same as the primary business information in Part 2. If this option is selected, the relevant information will be added below. □ New information added below □ Address is for a non-U.S. location (do not select if address is for U.S. territory) Street address (line 1) ______________________ Street address (line 2) (optional) _____________________________ City _____________________________________ State/U.S. Territory ______________________________ Zip/Postal code (optional for non-U.S. locations)______________________________________ Province/Country __________________________________ Email______________________________ Telephone number __________________________ Violations of Federal or state securities laws Has the individual being authorized as Prospective Account Administrator 1 been criminally convicted as a result of a Federal or state securities law violation, or civilly or administratively enjoined, barred, suspended, or banned in any capacity (e.g., officer or director bar, prohibition from associating with brokers, dealers, investment advisers, and/or other securities entities, or bar from participation in certain industries), as a result of a Federal or state securities law violation? □ Yes □ No If you indicate “Yes,” the SEC staff may contact you to determine your eligibility for EDGAR access. __________________________ Prospective Account Administrator 2 Enter full legal name, including middle name First name _________________________________________________ Middle name _________________________________________________ □ No middle name Last name ________________________________________________ Suffix _________________________________ Business title/position ____________________________ Is Prospective Account Administrator 2 the applicant (for an individual applicant), or an employee of the applicant or its affiliate (for a company applicant)? □ Yes □ No Provide the full legal name of the prospective account administrator’s employer and the employer’s CIK, if any. In addition, you must attach to your submission a notarized power of attorney authorizing the individual as an account administrator to manage the applicant’s EDGAR account, as set forth more fully in Part 6 of this form. Employer (full legal name) ______________________________________ 200 CIK of employer (if any) _________________ Business address and contact information □ Contact information is the same as the mailing address and preferred contact information in Part 1. If this option is selected, the relevant information will be added below. □ Contact information is the same as the primary business information in Part 2. If this option is selected, the relevant information will be added below. □ New information added below □ Address is for a non-U.S. location (do not select if address is for U.S. territory) Street address (line 1) ______________________ Street address (line 2) (optional) _____________________________ City ____________________________ State/U.S. Territory _____________________ Zip/Postal code ____________________________(optional for non-U.S. locations) Province/Country ________________________ Email ___________________ Telephone number ______________ Violations of Federal or state securities laws Has the individual being authorized as Prospective Account Administrator 2 been criminally convicted as a result of a Federal or state securities law violation, or civilly or administratively enjoined, barred, suspended, or banned in any capacity (e.g., officer or director bar, prohibition from associating with brokers, dealers, investment advisers, and/or other securities entities, or bar from participation in certain industries), as a result of a Federal or state securities law violation? □ Yes □ No If you indicate “Yes,” the SEC staff may contact you to determine your eligibility for EDGAR access. PART 4 – BILLING INFORMATION (To be completed only by company applicants and filing agents) Billing contact for SEC fee account and billing Enter full legal name, including middle name First name ________________________________ Middle name _____________________________ □ No middle name Last name ________________________________ Suffix _________________________________ 201 Business title/position _______________________ Employer _________________________________ Billing business address and contact information □ Contact information is the same as the mailing address and preferred contact information in Part 1. If this option is selected, the relevant information will be added below. □ Contact information is the same as the primary business information in Part 2. If this option is selected, the relevant information will be added below. □ New information added below □ Address is for a non-U.S. location (do not select if address is for U.S. territory) Street address (line 1) ______________________ Street address (line 2) (optional) _____________________________ City ____________________________________ State/U.S. Territory______________________________ Zip/Postal code (optional for non-U.S. locations)_____________________________________ Province/Country _________________________________ Email ___________________________ Telephone number ________________________ Violations of Federal or state securities laws Has the billing contact been criminally convicted as a result of a Federal or state securities law violation, or civilly or administratively enjoined, barred, suspended, or banned in any capacity (e.g., officer or director bar, prohibition from associating with brokers, dealers, investment advisers, and/or other securities entities, or bar from participation in certain industries), as a result of a Federal or state securities law violation? □ Yes □ No If you indicate “Yes,” the SEC staff may contact you to determine your eligibility for EDGAR access. PART 5 – SIGNATURE (To be completed by all applicants) An authorized individual of the applicant must sign Form ID. Refer to the EDGAR Filer Manual, Volume I for the definition of authorized individual and additional relevant information. By signing Form ID, the authorized individual authorizes the prospective account administrator(s) listed on Form ID to manage the filer’s EDGAR account on EDGAR on the filer’s behalf. Enter full legal name, including middle name 202 First name ___________________________________________ Middle name _________________________________________ □ No middle name Last name ___________________________________________ Suffix _________________________________ Business title/position __________________________________ Employer_____________________________________________ Business address and contact information □ Contact information is the same as the mailing address and preferred contact information in Part 1. If this option is selected, the relevant information will be added below. □ Contact information is the same as the primary business information in Part 2. If this option is selected, the relevant information will be added below. □ New information added below □ Address is for a non-U.S. location (do not select if address is for U.S. territory) Street address (line 1) ______________________ Street address (line 2) (optional) _____________________________ City ____________________________________ State/U.S. Territory _____________________________ Zip/Postal code (optional for non-U.S. locations)____________________________________Province/Country___________________ ______________ Email___________________________ Telephone number ________________________ Violations of Federal or state securities laws Has the authorized individual signing this application been criminally convicted as a result of a Federal or state securities law violation, or civilly or administratively enjoined, barred, suspended, or banned in any capacity (e.g., officer or director bar, prohibition from associating with brokers, dealers, investment advisers, and/or other securities entities, or bar from participation in certain industries), as a result of a Federal or state securities law violation? □ Yes □ No If you indicate “Yes,” the SEC staff may contact you to determine your eligibility for EDGAR access. Authorized individual signature___________________________________________________ [Notary seal] Date_______________________________________________________________________ 203 Is Form ID being signed pursuant to a Power of Attorney? □ Yes □ No Person signing Power of Attorney, if application is made pursuant to a Power of Attorney. Refer to the EDGAR Filer Manual, Volume I for more information. Enter full legal name, including middle name First name ___________________ Middle name _________________ □ No middle name Last name ___________________ Suffix _________________________________ Business title/position ________________________________ Employer__________________________________________ Person signing Power of Attorney business address and contact information □ Contact information is the same as the mailing address and preferred contact information in Part 1. If this option is selected, the relevant information will be added below. □ Contact information is the same as the primary business information in Part 2. If this option is selected, the relevant information will be added below. □ New information added below □ Address is for a non-U.S. location (do not select if address is for U.S. territory) Street address (line 1) ______________________ Street address (line 2) (optional) _____________________________ City ____________________________________ ____________ State/U.S. Territory ____________________________ Zip/Postal code (optional for non-U.S. locations)____________________________________ Province/Country__________________________________ Email ___________________________ Telephone number ________________________ Violations of Federal or state securities laws Has the person who signed the Power of Attorney been criminally convicted as a result of a Federal or state securities law violation, or civilly or administratively enjoined, barred, suspended, or banned in any capacity (e.g., officer or director bar, prohibition from associating with brokers, dealers, investment advisers, and/or other securities entities, or bar from participation in certain industries), as a result of a Federal or state securities law violation? □ Yes □ No If you indicate “Yes,” the SEC staff may contact you to determine your eligibility for EDGAR access. 204 PART 6 – DOCUMENTS (To be completed by all applicants) All filers must upload a notarized Form ID authentication document to EDGAR as a PDF attachment submitted with your Form ID. See the EDGAR Filer Manual, Volume I, for more information about the notarized authentication document. Other documents to be uploaded in certain circumstances: • Prospective account administrator(s) not employed by the applicant, including filing agents and other third parties acting on behalf of the applicant: Must upload to EDGAR a notarized Power of Attorney clearly indicating that an authorized individual of the applicant, as defined in the EDGAR Filer Manual, Volume I, gives the individual(s) named as a prospective account administrator(s) the authority to act as the applicant’s account administrator(s) and manage the applicant’s EDGAR account. Applicants for access to an existing CIK account: Must upload to EDGAR documents that clearly establish the applicant’s authority over the company or individual whose name currently is listed in EDGAR on the existing CIK account. • GENERAL INSTRUCTIONS All companies and individuals seeking access to file on EDGAR must refer to Rules 10 and 11 of Regulation S-T, Volume I of the EDGAR Filer Manual, and these instructions. All applicants must: (1) Complete and submit Form ID in electronic format on the EDGAR Filer Management website; and (2) Create a copy of the completed, electronically submitted Form ID; have an authorized individual of the filer sign it in the “Form ID: Notarized Authentication” part in the presence of an official notary public; and upload that authenticating document to the EDGAR Filer Management website. Before beginning: Form ID must be completed and submitted by an individual authorized by the applicant to do so. • • An account administrator is a person authorized by the filer to manage the filer’s EDGAR account on EDGAR on behalf of the filer. Each applicant must identify one or more prospective account administrator(s) that the 205 • applicant authorizes on Form ID. If the Form ID application is granted, the prospective account administrator(s) listed on Form ID will become the initial account administrators of the applicant. Account administrators must create individual account credentials in the manner specified in the EDGAR Filer Manual. When entering email addresses for individuals on Form ID, note that email addresses may be visible to other persons with access to the EDGAR Filer Management dashboard. Accordingly, individuals should enter email addresses that they intend to use for EDGAR and other business purposes, which may be different from the email address that they use for personal purposes. Email addresses that individuals provide to Login.gov for individual account credentials should match the email addresses they provide on Form ID. The “EDGAR Filer Manual Volume I: General Information” contains additional requirements regarding how to file electronically, including how to obtain individual account credentials, authorize account administrators, and use the CIK and CCC. Note that information submitted on Form ID may become public. Do not include personally identifiable information, such as personal addresses and contact information that the applicant does not wish to become public. Misstatements or omissions of fact in connection with an application for EDGAR access and/or in a submission on EDGAR may constitute a criminal violation under 18 U.S.C. sections 1001 and 1030 and/or a violation of other criminal and civil laws. If the SEC has reason to believe that an application for EDGAR access and/or a submission on EDGAR is misleading, manipulative, and/or unauthorized, the SEC may prevent acceptance or dissemination of the application/submission and/or prevent future submissions or otherwise remove a filer’s access to EDGAR pursuant to Rule 15 of Regulation S-T, 17 CFR 232.15. Complete all items that are relevant to the application. If an item does not apply to the application, leave that item blank. For assistance with procedural and technical questions about electronic filing or substantive questions, see the “EDGAR Filer Manual Volume II: Section 2.3.4 (Getting Help with EDGAR). PART 1 — APPLICATION FOR EDGAR ACCESS (To be completed by all applicants) Indicate whether EDGAR access is being requested for a new CIK account or an existing CIK account. If access is being requested for an existing CIK account, indicate the basis for the request—whether the applicant is a broker-dealer or “paper filer” who wants to start filing electronically on EDGAR, lost electronic access to their CIK account, or is the legal successor of 206 the filer named on the existing CIK account but did not receive access from that filer. A filer that has lost electronic access because it failed to satisfy annual confirmation requirements or because its account administrators are no longer available should select the “lost electronic access” option. If the applicant is applying for access to an existing CIK account, some of the filer’s currently publicly available corporate and contact information will be prepopulated into Form ID. That information can be updated on Form ID, but doing so will not update the filer’s information in EDGAR (other than the filer’s account administrator information). Changes to the filer’s corporate and contact information must be made in EDGAR after the applicant’s Form ID application is granted. However, filers who are broker-dealers that obtained an EDGAR account by submitting a Form BD to FINRA would need to update their information with FINRA directly. Broker-dealers that have made a full withdrawal of their registration, by submitting a Form BDW that has been accepted, should apply for a new EDGAR account instead of applying for access to the existing EDGAR account associated with the withdrawn registration. Applicants should identify themselves as individuals or companies. Provide the applicant’s full legal name in English. Note that the applicant’s name will be automatically conformed following submission to meet EDGAR standards. Specifically: 1. Leading and trailing blank spaces will be removed. Any embedded sequences of two or more spaces will be replaced with a single space. 2. For companies, the following words will be removed if they are the first word of the name: A An The 3. For companies, the following text substitutions will be applied to all words except the first: Original Text Conformed Text Company Co Corporation Corp Incorporated Inc Incorporation Inc And & 4. For companies, the following substitution will be applied if the word is neither the first in the name, nor is immediately followed by the word “Partnership”: Original Text Conformed Text Limited Ltd 207 5. For individuals, the name components (“Last,” “First,” “Middle,” and “Suffix”) will be combined left-to-right (separated by spaces) into a single field and truncated at 150 characters. 6. For individuals with a suffix, the following text substitutions will be applied: Original Text Conformed Text Junior JR Senior SR Select one (1) applicant type to indicate whether the applicant will send electronic submissions as one of the listed filer types. Indicate whether the filer is applying for EDGAR access to submit non-public draft registration or offering statements on submission type DRS or DOS. If so, the applicant’s new CIK number and EDGAR contact information will not be listed on the public EDGAR company database until the applicant makes a public filing. Provide the preferred mailing address and contact information for the applicant. A company applicant should provide information for the department, unit, or group most directly responsible for the filer’s EDGAR submissions. This may be the applicant’s registered agent, law firm, or filing agent. In that case, identify them in the mailing address and contact information, but do not include any specific individuals by name or any personally identifiable information that you do not want to make publicly available because the mailing address and contact information will generally be publicly available. Indicate whether the applicant has been criminally convicted as a result of a Federal or state securities law violation, or civilly or administratively enjoined, barred, suspended, or banned in any capacity (e.g., officer or director bar, prohibition from associating with brokers, dealers, investment advisers, and/or other securities entities, or bar from participation in certain industries), as a result of a Federal or state securities law violation. PART 2 —COMPANY INFORMATION (To be completed only by applicants who are not natural persons) Provide the applicant’s tax or Federal identification number, the number issued by the Internal Revenue Service. (This does not apply to individuals. Accordingly, do not enter a Social Security number.) If an investment company applicant is organized as a series company, the investment company may use the tax or Federal identification number of any one of its constituent series. Applicants that have applied for but not yet received their tax or Federal identification number and foreign applicants that do not have a tax or Federal identification number must include all zeroes. Provide the applicant’s legal entity identifier (LEI), if any. 208 Indicate whether applicant is in good standing in its state or country of incorporation. Generally, this means a company is legally authorized to do business in that state or country and has filed all required reports and paid all related fees to the relevant jurisdiction. Provide the filer’s state of incorporation and fiscal year end. Select “none” for state of incorporation and “N/A” for fiscal year end if the filer has not incorporated. Foreign filers should also include their country of organization. If the filer’s fiscal year does not end on the same date each year (e.g., falls on last Saturday in December), the filer must enter the date the current fiscal year will end. Provide the company’s primary website, if any. Provide the applicant company’s primary business information or that of the company’s registered agent. Do not enter the address of the company’s law firm or filing agent. Indicate whether the filer is a single-member company. This refers to a company that only has a single individual who acts as the sole equity holder, director, and officer (or, in the case of an entity without directors and officers, holds position(s) performing similar activities as a director and officer). PART 3 — PROSPECTIVE ACCOUNT ADMINISTRATOR INFORMATION (To be completed by all applicants) Identify the individuals being authorized as prospective account administrator(s) who will manage the filer’s EDGAR account on the filer’s behalf, should the Form ID application be granted, including the account administrator(s) business title(s)/position(s), address(es), and contact information. Individual filers and single-member companies must authorize at least one prospective account administrator. All other filers must authorize two prospective account administrators on Form ID. Additional account administrators may be added through the Filer Management dashboard, should the Form ID application be granted. For each individual being authorized as a prospective account administrator, indicate whether the individual has been criminally convicted as a result of a Federal or state securities law violation, or civilly or administratively enjoined, barred, suspended, or banned in any capacity (e.g., officer or director bar, prohibition from associating with brokers, dealers, investment advisers, and/or other securities entities, or bar from participation in certain industries), as a result of a Federal or state securities law violation. If an individual being authorized as a prospective account administrator is not the applicant (in the case of an individual applicant), or an employee of the applicant or its affiliate (in the case of a company applicant), disclose that fact and provide the name and CIK (if any) of the prospective account administrator’s employer. In addition, a notarized power of attorney authorizing the prospective account administrator must be attached in Part 6. 209 For more information on account administrators, see Rules 10 and 11 of Regulation S-T and Volume I of the EDGAR Filer Manual. PART 4 — BILLING INFORMATION (To be completed only by company applicants and filing agents) Billing information is used if questions arise related to account and billing matters, such as: 1. 2. 3. Accounts activity statements Account receivable letters Refund questions Identify the individual who should receive account information and/or billing invoices from the SEC and include their email address. Ensure the accuracy of the email address and maintain an accurate, active email address in the EDGAR Filing website. EDGAR will send communications to the email address if there are questions pertaining to the account and billing information, and failure to maintain an accurate, active email address could result in failure to receive EDGAR account statements. Indicate whether the billing contact has been criminally convicted as a result of a Federal or state securities law violation, or civilly or administratively enjoined, barred, suspended, or banned in any capacity (e.g., officer or director bar, prohibition from associating with brokers, dealers, investment advisers, and/or other securities entities, or bar from participation in certain industries), as a result of a Federal or state securities law violation. PART 5 — SIGNATURE (To be completed by all applicants) If the applicant is not a natural person, indicate the capacity in which the authorized individual signs the Form ID on behalf of the applicant (business title/position). The authorized individual must be an individual with the authority to legally bind the applicant, or an individual with a power of attorney from an individual with the authority to legally bind the applicant for purposes of Form ID. If the applicant is an individual, the applicant must sign the Form ID and should list their business title/position as “applicant,” unless the applicant executes a notarized power of attorney authorizing a third-party individual to sign the Form ID on the applicant’s behalf. Indicate whether the authorized individual signing the Form ID has been criminally convicted as a result of a Federal or state securities law violation, or civilly or administratively enjoined, barred, suspended, or banned in any capacity (e.g., officer or director bar, prohibition from associating with brokers, dealers, investment advisers, and/or other securities entities, or bar from participation in certain industries), as a result of a Federal or state securities law violation. Indicate whether Form ID is being signed pursuant to a power of attorney. 210 If another person signs on behalf of the applicant, confirm in writing the authority of that person to sign by attaching a notarized power of attorney to the Form ID. For more information on the documentation needed to confirm the authority of a person signing the Form ID on behalf of the applicant, see Volume I of the EDGAR Filer Manual. • • If relevant, provide the name, address, and contact information for the person signing the power of attorney. Indicate whether the person signing the power of attorney has been criminally convicted as a result of a Federal or state securities law violation, or civilly or administratively enjoined, barred, suspended, or banned in any capacity (e.g., officer or director bar, prohibition from associating with brokers, dealers, investment advisers, and/or other securities entities, or bar from participation in certain industries), as a result of a Federal or state securities law violation. For Form IDs signed in connection with a power of attorney document, the person signing the power of attorney should indicate in the business title/position field: “By POA from [(a) name of the authorized individual signing the power of attorney (if opening an account for a natural person); or (b) name and business title/position of the authorized individual signing the power of attorney (if opening an account for a company)].” For example, a filing agent signing Form ID pursuant to a power of attorney from Roger Smith, the Chief Executive Officer of the applicant, could provide in the business title/position field: “By POA from Roger Smith, CEO.” The applicant must upload a notarized copy of Form ID and any other required attachments to the electronic Form ID filing. The Form ID authenticating document must be attached to the electronic Form ID filing in PDF format. PDF attachments cannot: (i) be blank; (ii) be imageonly; or (iii) contain active contents (Actions, embedded JavaScript, etc.), external references (Destinations, Hyperlinks, etc.), passwords, or document security controls. PART 6 — DOCUMENTS (To be completed by all applicants) Attach the mandatory notarized authenticating document in PDF format (Form ID authenticating document). The mandatory Form ID authenticating document must include the following information: • • • • Signature of Authorized Individual Printed Name of Signature Title of Person Signing Notary Signature and Seal Other documents to be provided with the Form ID must be attached in this part as well, including power of attorney documents. If an account administrator is not an employee of the applicant or its affiliates, or if the individual signing Form ID is doing so pursuant to a power of attorney, a notarized power of attorney must be attached. Do not upload documents containing potentially sensitive personally identifiable information, such as birth certificates, driver’s licenses, or passports. Applicants seeking access to an existing CIK must upload 211 documents that clearly establish their authority over the company or individual whose name is currently listed in EDGAR on the existing CIK account. For more information on documents that may need to be submitted with the Form ID application, see Volume I, section 3, of the EDGAR Filer Manual. 212