Document

13976 Itemized Statement Component of Advisee List

ICR 200803-1545-009 · OMB 1545-1686 · Object 6537201.

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1545-1686 can be found here:

Document [xls]

Download: xls | pdf | html

Overview

Form 13976	Itemized Statement Component of Advisee List

*Section I*	*Material Advisor Information*

Name (Last/Company)	First Name	Street Address	City	State	Zip Code	Telephone Number	Identifying Number	Person to Contact

*Section II*	*Reportable Transaction Information*

Name of Reportable Transaction		Type(s) of ReportableTransaction		Reportable Transaction #			Published Guidance # (TOI or Listed Transactions)

*Section III*	*Other Material Advisors to the Reportable Transaction*

Name (Last/Company)	First Name	Street Address	City	State	Zip Code	Identifying Number	Signed Designation Agreement (Yes or No)



*Section IV*	*Advisee Information*

Name (Last/Company)	First Name	Street Address	City	State	Zip Code	Identifying Number	Date Entered into Transaction	Amount Invested

Form 13976

Itemized Statement Component of Advisee List

Section V

Schedule of Tax Treatment

Name (Last/Company)

First Name

Identifying Number

Summary or Schedule of the Tax Treatment that Advisee is Expected or Intended to Derive from Participation in Reportable Transaction

Associated Documents, such as Exhibit and/or Bates Numbers Optional

File Type	application/vnd.ms-excel
File Title	13976 Itemized Statement Component of Advisee List
Author	LocalUser
Last Modified By	J11FB
File Modified	2008-03-25
File Created	2007-10-12