Form CFPORTAL Application Or Amendment To Application For Registration Or Withdrawal {CFPORTAL}

1 SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM FUNDING PORTAL APPLICATION OR AMENDMENT TO APPLICATION FOR REGISTRATION OR WITHDRAWAL FROM REGISTRATION AS FUNDING PORTAL UNDER THE SECURITIES EXCHANGE ACT OF 1934 WARNING: Failure to complete this form truthfully, to keep this form current and to file accurate supplementary information on a timely basis, or the failure to keep accurate books and records or otherwise to comply with the provisions of law applying to the conduct of business as a funding portal, would violate the Federal securities laws and may result in disciplinary, administrative, injunctive or criminal action. Check the appropriate box: This is: an initial application to register as a funding portal with the SEC.an amendment to any part of the funding portal222s most recent Form Funding Portal,including a successor registration.a withdrawal of the funding portal222s registration with the SEC. Schedule A must be completed as part of all initial applications. Amendments to Schedule A must be provided on Schedule B. Schedule C must be completed by nonresident funding portals. If this is a withdrawal of a funding portal222s registration, complete Schedule D. If this is an amendment to any part of the funding portal222s most recent Form Funding Portal, provide an explanation describing the amendment: Item 1 226 Identifying Information Exact name, principal business address, mailing address, if different, and contact information of the funding portal: A.Full name of the funding portal: B.Name(s)/Website URL(s) under which business is conducted, if different from Item1A: C.IRS Empl. Ident. No.: OMB OMB Number: 3235-0727 Expiration Date: /31/ Estimated average burden hours per response: 2.75 American LegalNet, Inc. www.FormsWorkFlow.com 2 D. If a name and/or website URL in (1A) or (1B) has changed since the funding portal222s most recent Form Funding Portal, enter the previous name and/or website URL and specify whether the name change is of the funding portal name (1A), or name/website URL (1B). Previous name(s) or website URL(s): E. Funding portal222s main street address (Do not use a P.O. Box): F. Mailing address(es) (if different) and office locations (if more than one): G. Contact Information: Telephone Number: Fax Number: Email Address: H. Contact Employee Information: Name: Title: Direct Telephone Number: Fax Number: Direct Email Address: I. Month applicant222s fiscal year ends: J. Registrations Was the applicant previously registered on Form Funding Portal as a funding portal or with the Commission in any other capacity? Yes SEC File No.: K. Foreign registrations (1) Is the applicant registered with a foreign financial regulatory authority? Answer 223no224 even if affiliated with a business that is registered with a foreign financial regulatory authority. American LegalNet, Inc. www.FormsWorkFlow.com 3 YesNo If 223yes,224 complete Section K.2. below. (2)List the name, in English, of each foreign financial regulatory authority andcountry with which the applicant is registered. A separate entry must becompleted for each foreign financial regulatory authority with which theapplicant is registered. English Name of Foreign Financial Regulatory Authority: Registration Number (if any): Name of Country: Item 2 226 Form of Organization A.Indicate legal status of applicant. CorporationLimited Liability Company Sole ProprietorshipOther (please specify) Partnership B.If other than a sole proprietor, indicate date and place applicant obtained its legalstatus (i.e., state or country where incorporated, where partnership agreement wasfiled, or where applicant entity was formed): State/Country of formation:Date of formation: Item 3 226 Successions A.Is the applicant at the time of this filing succeeding to the business of a currentlyregistered funding portal? YesNo Do not report previous successions already reported on Form Funding Portal. If 223yes,224 complete Section 3.B. below. B.Complete the following information if succeeding to the business of a currently-registered funding portal. If the applicant acquired more than one funding portalin the succession being reported on this Form Funding Portal, a separate entrymust be completed for each acquired firm. American LegalNet, Inc. www.FormsWorkFlow.com 4 Name of Acquired Funding Portal: Acquired Funding Portal222s SEC File No.: C. Briefly describe details of the succession including any assets or liabilities not assumed by the successor. Item 4 226 Control Relationships In this Item, identify every person that, directly or indirectly, controls the applicant, controls management or policies of the applicant, or that the applicant directly or indirectly controls. If this is an initial application, the applicant also must complete Schedule A. Schedule A asks for information about direct owners and executive officers. If this is an amendment updating information reported on the Schedule A filed with the applicant222s initial application, the applicant must complete Schedule B. Item 5 226 Disclosure Information In this Item, provide information about the applicant222s disciplinary history and the disciplinary history of all associated persons or control affiliates of the applicant (as applicable). This information is used to decide whether to revoke registration, to place limitations on the applicant222s activities as a funding portal, and to identify potential problem areas on which to focus during examinations. One event may result in the requirement to answer 223yes224 to more than one of the questions below. Check all answers that apply. Refer to the Explanation of Terms section of Form Funding Portal Instructions for explanation of italicized terms. If the answer is 223yes224 to any question in this Item, the applicant must complete the appropriate Disclosure Reporting Page (223DRP224) (FP) 226 Criminal, Regulatory Action, Civil Judicial Action, Bankruptcy/SIPC, Bond, or Judgment/Lien, as applicable. Criminal Disclosure If the answer is 223yes224 to any question below, complete a Criminal DRP. A. In the past ten years, has the applicant or any associated person: American LegalNet, Inc. www.FormsWorkFlow.com 5 (1) been convicted of any felony, or pled guilty or nolo contendere (223no contest224) to any charge of a felony, in a domestic, foreign, or military court? Yes No The response to the following question may be limited to charges that are currently pending: (2) been charged with any felony? Yes No B. In the past ten years, has the applicant or any associated person: (1) been convicted of any misdemeanor, or pled guilty or nolo contendere (223no contest224), in a domestic, foreign, or military court to any charge of a misdemeanor in a case involving: investment-related business, or any fraud, false statements, or omissions, wrongful taking of property, bribery, perjury, forgery, counterfeiting, extortion, or a conspiracy to commit any of these offenses? Yes No The response to the following question may be limited to charges that are currently pending: (2) been charged with a misdemeanor listed in Item 5-B(1)? Yes No Regulatory Action Disclosure If the answer is 223yes224 to any question below, complete a Regulatory Action DRP. C. Has the SEC or the Commodities Futures Trading Commission (223CFTC224) ever: (1) found the applicant or any associated person to have made a false statement or omission? Yes No (2) found the applicant or any associated person to have been involved in a violation of any SEC or CFTC regulations or statutes? American LegalNet, Inc. www.FormsWorkFlow.com 6 Yes No (3) found the applicant or any associated person to have been a cause of the denial, suspension, revocation, or restriction of the authorization of an investment-related business to operate? Yes No (4) entered an order against the applicant or any associated person in connection with investment-related activity? Yes No (5) imposed a civil money penalty on the applicant or any associated person, or ordered the applicant or any associated person to cease and desist from any activity? Yes No D. Has any other federal regulatory agency, any state regulatory agency, or any foreign financial