Form 17-H Risk Assessment Report For Brokers And Dealers (SEC2332) {17-H}

United States Securities and Exchange Commission Washington, D.C. 20549 FORM 17-H RISK ASSESSMENT REPORT FOR BROKERS AND DEALERS PART I Risk Assessment Reporting Requirements for Brokers and Dealers NAME OF REPORTING BROKER-DEALER 14 SEC FILE NO. 12 CRD NO.16 ADDRESS OF PRINCIPAL PLACE OF BUSINESS 18FIRM I.D. NO. 20FOR PERIOD BEGINNING (MM/DD/YY) , . 22 FILING TYPE: (Check Appropriate Boxes) QUARTERLY ANNUAL AMENDED 262830AND ENDING (MM/DD/YY) 24NAME AND TELEPHONE NUMBER OF PERSON TO CONTACT IN REGARD TO THIS REPORT32NAME(S) OF MATERIAL ASSOCIATED PERSONS CONTAINED IN THIS REPORT: 3436384042NAME OF ASSOCIATED BROKER-DEALER(S) NOT FILING (If applicable) 4446485052ATTENTION Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 247 1001 and 15 U.S.C. 247 78ff(a). Intentional misstatements or omissions of facts may also result in civil fines and other sanctions pursuant to Section 20 of the Securities Exchange Act of 1934. The person signing this report represents hereby that all information contained in this Form is true, correct and complete. It is understood that all information in this Form is considered an integral part of this Form and that the submission of any amendment represents that all unamended information remains true, correct and complete as previously filed. Pursuant to the Securities Exchange Act of 1934, the undersigned has caused this report to be signed on its behalf in the City of and State ofon the day of20(Name of Broker-Dealer) (Signature and Title of Person Duly Authorized to Submit This Report) Persons who respond to the collection of information contained in this form are not required to037 respond unless the form displays a currently valid OMB control number. American LegalNet, Inc. www.FormsWorkFlow.com GENERAL INSTRUCTIONS002 1. This Form consists of two parts. Part I consists of the organizational, policy and legal information requiredby paragraphs (a)(1)(i) through (iii) of section 240.17h-1T, together with the financial statements required byparagraphs (a)(1)(iv) and (v) of section 240.17h-1T. Part II contains line items for reporting the numerical andother data required by paragraphs (a)(1)(vi) through (x) of section 240.17h-1T. 2. Report as of the last day of the fiscal quarter. This Form is to be filed within 60 calendar days of the end ofeach fiscal quarter by brokers and dealers concerning each Material Associated Person (as defined in TemporaryRules 17h-1T and 17h-2T). The Form for the fourth fiscal quarter shall be filed within 60 calendar days of theend of the fiscal year. The cumulative year-end financial statements required by paragraphs (a)(1)(iv) and (v)of section 240.17h-1T may be filed separately within 105 calendar days of the end of the fiscal year. 3. In the event a broker or dealer is associated with one or more other registered brokers or dealers, each brokeror dealer is required to file a separate Form 17-H. The Commission may exempt from the filing requirementsall brokers or dealers associated with a broker or dealer that has been designated a 223Reporting Broker or Dealer.224The term 223Reporting Broker or Dealer224 shall have the meaning set forth in Rules 17h-1T and 17h-2T. A broker or dealer seeking designation as a Reporting Broker or Dealer must apply to the Commission for an exemptionpursuant to Rule 17h-2T. Pending such designation, each broker or dealer associated with the broker or dealerrequesting such designation as a Reporting Broker or Dealer is required to file a separate Form 17-H. 4. The information requested in Part II of this Form shall be completed separately for each Material AssociatedPerson, even if the financial data contained in the broker or dealer222s Form X-17A-5 contains information concerning a Material Associated Person. The broker-dealer should not include information concerning itsactivities in the information required by Part II of this Form if such information is filed with the Commission aspart of the broker-dealer222s Form X-17A-5 or Form G-405. ITEM 1 ORGANIZATIONAL CHART REFLECTING ASSOCIATED PERSONS AND THE BROKER-DEALER 1. Provide a copy of the organizational chart maintained by the broker or dealer pursuant to paragraph (a)(1)(i)of section 240.17h-1T. 2. The information provided pursuant to this Item should be included in the first Form 17-H filed by the brokeror dealer and in the year-end filing. Quarterly updates should be provided only where a material change in theinformation provided to the Commission has occurred. ITEM 2 RISK MANAGEMENT AND OTHER POLICIES 1. Provide copies of the financing, capital adequacy, and risk management and other policies, procedures orsystems maintained by the broker-dealer pursuant to paragraph (a)(1)(ii) of section 240.17h-1T.2. The information provided pursuant to this Item should be included in the first Form 17-H filed by the brokeror dealer. Quarterly updates should be provided only where a material change in the information provided to theCommission has occurred. ITEM 3 LEGAL PROCEEDINGS 1. Provide the description of any material pending legal or arbitration proceedings maintained by the broker ordealer pursuant to paragraph (a)(1)(iii) of section 240.17h-1T.2. The information provided pursuant to this Item should be included in the first Form 17-H filed with theCommission. Quarterly updates should be provided only where a material change in the information providedto the Commission has occurred. ITEM 4 FINANCIAL STATEMENTS 1. Provide the information required to be maintained by the broker or dealer pursuant to paragraphs (a)(1)(iv)and (a)(1)(v) of section 240.17h-1T. The financial statements may be presented on an unaudited basis. The statement of cash flows and the notes to financial statements may be omitted for the consolidating financial statements. Entities using accounting principles other than U.S. GAAP should indicate in a note the accountingprinciples used.2. The consolidating financial statements must be presented on a subsidiary basis and shall indicate whichsubsidiaries are Material Associated Persons. American LegalNet, Inc. www.FormsWorkFlow.com PART II GENERAL INSTRUCTIONS FOR PART II OF THIS FORM 1. Provide the following information for each Material Associated Person as of the end of the quarter. Indicate the name of each Material Associated Person in a separate column or complete a separate Part II for each Material Associated Person. In the event a separate listing of a position, financial instrument or otherwise is required pursuant to any of the provisions of section 240.17h-1T, the broker or dealer should indicate as such in the appropriate section of this Part II. Where appropriate, indicate long and short positions separately. (Report amounts in thousands) Material Associated Person: I. AGGREGATE SECURITIES AND COMMODITIES POSITIONS ........................................................002 ..........................................................002 1. U.S. Treasury securities ..................................................................002 ...............................................................002 .............................................................002 .............................................................002 ...................................................................002 .............................................................002 ..............002 ................................002 ...................................................................002 .................................................................002 .........................................................................002 ......................................................................002 ...........................................................................002 ......................................................................002 ...................................................................002 ..............................................................................002 .................................................................................002 ....................002 ................