Form SEC1936 Form N-6F

UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

FORM N-6F

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3235-0238
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March 31, 2012
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NOTICE OF INTENT TO ELECT TO BE SUBJECT TO SECTIONS 55 THROUGH 65
OF THE INVESTMENT COMPANY ACT OF 1940
The undersigned hereby notifies the Securities and Exchange Commission that it intends to file a notification of election to be subject
to sections 55 through 65 of the Investment Company Act of 1940 (the “Act”) and in connection with such notice submits the following
information:
Name:*
Address of Principal Business Office (No. & Street, City, State, Zip Code):
Telephone Number (including area code):
Name and address of agent for service of process:

The undersigned company hereby notifies the Securities and Exchange Commission that it intends to file a notification of election
to be subject to sections 55 through 65 of the Act within ninety days of the date of this filing. The company would be excluded from
the definition of an investment company by section 3(c)(1) of the Act, except that it presently proposes to make a public offering of its
securities as a business development company.
SIGNATURE
Pursuant to the requirements of section 6(f) of the Act, the undersigned company has caused this notice of intent to elect to be subject
to sections 55 through 65 of the Act pursuant to section 54(a) of the Act to be duly executed on its behalf in the city of
and the state of

on the

day of

[SEAL]

By

.

(Signature)
(Name of Company)

(Name of director, officer or general partner
signing on behalf of the company)

Attest:

(Name)

, 20

(Title)

(Title)

*In selecting a name a company should consider the following: (a) section 35(d) of the Act; (b) the current list of companies registered under the Act (in order to ascer-

SEC1936 (03-01)

Persons who respond to the collection of information contained in this form are not required
to respond unless the form displays a currently valid OMB control number.

INSTRUCTIONS FOR FORM N-6F
Read instructions carefully before preparing this notice. It may be returned as not acceptable for filing unless it is prepared, executed,
and filed substantially in accordance with these instructions. This form is not to be used as a blank form to be filled in, but only as a guide
in the preparation of a notice of intent to file a notification of election. The form should be filed on paper 8 1/2 x 11 inches in size.
(a) This form shall be used pursuant to section 6(f) of the Act to notify the Commission of the company’s intent to file a notification of
election to be subject to sections 55 through 65 of the Act. The form should not be filed by a company that at the time of filing has
more than one hundred beneficial owners of its securities, or by a company that expects to have more than one hundred beneficial
owners of its securities before a notification of election will be filed. Such a company should consider whether or not it needs to
file a notification of registration under section 8(a) of the Act or a notification of election under section 54(a) of the Act.
(b) Signature.
An original and three copies of the notice of intent to file a notification of election shall be filed. The three copies may have facsimile or typed signatures. If the company is a business development company having a board of directors, the original notice of
intent to file a notification of election shall be signed on behalf of the company by a director, officer, or trustee. If the company is
a partnership, the original notice shall be signed by a general partner.
(c) Filing.
The notice of intent to elect and all inquiries and communication with respect thereto shall be forwarded to the Securities and
Exchange Commission, Washington, D.C. 20549.
(d) Fee.
There is no fee charged for filing the notice of intent to elect.
(e) SEC’s Collection of Information.
An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays
a currently valid control number. Filing of this Form is mandatory. The principal purpose of this collection of information is to
notify the Commission that the business development company intends to file a notification of election to be subject to sections
55 through 65 of the Act within ninety days of the date of this filing. The Commission estimates that the burden for completing
the Form will be approximately 0.5 hours per filing. Any person may direct to the Commission any comments concerning the
accuracy of the burden estimate of this Form and any suggestions for reducing this burden. This collection of information has
been reviewed by the Office of Management and Budget in accordance with the clearance requirements of 44 U.S.C. § 3507. The
responses to the collection of information will not be kept confidential.