Original Ticket Distributor Registration {TD-1A}

New York Form TD-1A(Rev ) STATE OF NEW YORKDEPARTMENT OF LAW INVESTOR PROTECTIONNEW YORK, NEW YORK 10 ORIGINAL TICKET DISTRIBUTOR REGISTRATION Please print or type the following information. Attach additional sheets where space provided is inadequate.All changes or modifications in the information herein shall be reported, within 20 days of such change ormodification, on form TD-2A.Name and address of theatre, stadium, garden, arena, or other place where theatre or sporting events are held.1.Name and Address of owner. 2.Name and address of operator or operating lessee of above-named theatre, stadium, garden, arena, etc.Name Address American LegalNet, Inc. www.FormsWorkFlow.com 3.State information listed below for all persons or firms directly or indirectly controlling the business of theowner as principals, officers, directors, trustees, controlling stockholders or managing agents:Social Security NumberName/Residence Address Date of Birth Position 4.State information listed below for all persons or firms directly or indirectly controlling the business of theoperator or operating lessee (if applicable) as principals, officers, directors, trustees, controlling stockholderor managing agents:Social Security NumberName/Residence Address Date of Birth Position 5.State information listed below regarding any other theatre personnel (Not otherwise given above) includingtreasurer, assistant treasurers, ticket sellers and any other person who, now or in the immediate future, forany period of time have control of the allocation or distribution of tickets of the above theatre (but notincluding subordinate personnel performing minor clerical functions):Social Security Number/Name/Residence Address Date of Birth Position American LegalNet, Inc. www.FormsWorkFlow.com 6.State information listed below for persons, above-named who have been convicted of any crime relating tothe sale of tickets to theatrical productions sporting events or violations of Article 23 or 25 of the Arts andCultural Affairs Law (or prior law, Articles 23-A and 26-A of the General Business Law):Name Crime Charged Date Court/State 7.State information listed below regarding above named persons who have been the subject of an order of theAttorney General cancelling or suspending his name from any ticket distributor registration or any amendmentthereto:Name of Theatre,Date of Stadium, Garden, Name Order Arena, etc. Suspension DATED: FILED BY: (SIGNED) (PRINT NAME AND POSITION) American LegalNet, Inc. www.FormsWorkFlow.com