Regulator - Add Form NF Mutual Fund Notice

* Indicates required field

State File Number:

This is an optional field for an in-state identifier for this Notice of Offering.

* CIK #:

Issuer Information

Issuer Name:

Address:

Address:

City:

State:

Zip:

Filing Notice Type

Open-End Mutual Fund Closed-End Mutual Fund Face Amount Certificate Collective Trust

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Initial Amendment Renewal Terminate Withdrawal

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Sales Report Increase Dollar Amount Name Change Address Change Contact Change Exemption Other

Oversale Increase

Oversale Adjustment Date:

Other Nature Of Changes:

Previous Fund Name:

Fund Details

Fund Name:

Security Description:

Prospectus:

Portfolio(s):

Class(es):

Fiscal Year End of Issuer:

Month:

Month January February March April May June July August September October November December

Day:

Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

N/A

Are all Securities described on this form offered in one prospectus?

Yes No

Filer Contact Information

* Indicates required field

* Contact Name:

Contact Title:

* Contact Firm:

* Contact Address:

Contact Address:

* Contact City:

* Contact State:

* Contact Zip:

* Contact Phone:

Contact FAX:

Contact Email:

Registration Information

* Indicates required field

Broker Dealer:

BD CRD #:

Fed. Id #:

SEC Reg #:

* State of Incorporation:

Select...

* Notice Period Details

Begin and End are only required if "Notice Period:" is selected.

Notice Period:

Begin:

End:

The issuer elects to have its notice filing made effective upon filing.

The issuer elects to have its notice filing period begin with SEC Effectiveness and thereby agrees to provide the above state prompt notice of such effectiveness.

Offering Amount

Indefinite Definite

Amount Offered:

Exemption Filing

Yes No

Details

Net Assets

Yes No

Amount

$ .00

Offering Amount Increase

For filings to increase the dollar amount of securities reported during the Notice Period provide the following:

Previous Amount:

$ .00

Amount of Increase:

$ .00

Cumulative Amount:

$ .00

Sales Report

Period Begin:

Period End:

Balance at Beginning of Period:

$ .00 N/A Indefinite

Additional Increases during:

$ .00 N/A Indefinite

Amount Available for Sale:

$ .00 N/A Indefinite

Sales During Period:

$ .00 N/A Indefinite

Unsold Balance at End of Period:

$ .00 N/A Indefinite

Signatures

Signature Date:

Signature:

Title:

Payment Details

The following form entry elements describe the entity making the payment.

Payer Name:

Company Name:

Telephone:

Payment Memo:

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