Last updated: 1/19/2022
Form X-17A-19 Report Of Change In Memberhip Status (SEC1414) {X-17A-19}
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Description
UNITED STATES002 SECURITIES AND EXCHANGE COMMISSION002 Washington, D.C. 20549002 FORM X-17A-19 002 002 002 002 1.Identify the self-regulatory organization filing this report. AMEX BSE CBOE CSE CHX ISE NASD NYSE PCX PHLX 2.The change in membership with the reporting self-regulatory organization is:(a) New Membership003 (b) Termination of Membership (c) Suspension of Membership(d) Reinstatement from Suspension (e) Change of Address (f) Other Change in Membership Status If (b), (c), (d) or (f) give a brief description of the circumstances 3.Provide the following information concerning the subject.Present Status: (a) thru (d)(a)Name (b) Corporation Partnership Sole Proprietor LLC -Other (c)SEC File No. (d)Principal Place of Business:(Number and Street) (City) 003(State) (Zip Code) 4.The subject is also a member of the:To be changed to (a) thru (d) (a)Name (b) Corporation Partnership Sole Proprietor LLC-Other (c)SEC File No. (d)Principal Place of Business:(Number and Street) (City) 003(State) (Zip Code) AMEX BSE CBOE CSE CHX ISE NASD NYSE PCX PHLX 5.The examining authority and SIPC collection agent prior to this change in membership status is: AMEX BSE CBOE CSE CHX ISE NASD NYSE PCX PHLX 6.Name of person completing report Title Effective Date Telephone No Signature of Change (ADVISE BROKER-DEALER OF ITS OBLIGATION TO AMEND ITS FORM BD OR FILE FORM BDW) RESERVED FOR SEC ACTION Examining Authority Not Changed Examining Authority Changed From to Signature Date INSTRUCTIONS ON BACK Persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. American LegalNet, Inc. www.FormsWorkFlow.com GENERAL INSTRUCTIONS FORM X-17A-19 1.003 This Form shall be completed and filed within 5 business days of the occurrence of one or more of the changes in membership status listed in Item 2 and/or 3 on this Form or promptly upon learning that such changes will occur. If the information first becomes available after the change in membership status has occurred, the Form shall be completed and filed promptly. 2.003 Original - Mail to: U.S. Securities and Exchange Commission Division of Market Regulation 100 F Street, N.E. Washington, D.C. 20549-6628 Copy No. 1 - Mail to:003 Securities Investor Protection Corporation002 805 15th Street, N.W., Suite 800002 Washington, D.C. 20005002 Copy No. 2:003 Retain for your files. 3.003 The original filed with the Securities and Exchange Commission and the copy filed with the Securities Investor Protection Corporation shall be executed with a manual signature by a duly authorized official of the national securities exchange or registered securities association (self-regulatory organization). 4.003 If the space provided in the Form for an answer to any Item is insufficient, the answer may be printed or typed on a separate insert page or pages which shall be incorporated into the statement by reference thereto in the space provided for the Item. 5.003 If any Item of the Form is inapplicable, a statement to that effect shall be made following the Item. 6.003 Change of member222s address is required to be reported only by the examining authority. 7.003 Copies of this Form may be obtained from the main office of the Securities and Exchange Commission in Washington, D.C. 8.003 The Securities and Exchange Commission will use a copy of this Form to notify Securities Investor Protection Corporation and the affected self-regulatory organizations of any action that is taken. (ADVISE BROKER-DEALER OF ITS OBLIGATION TO AMEND ITS FORM BD OR FILE FORM BDW) American LegalNet, Inc. www.FormsWorkFlow.com
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