Form FR G-2 FR G-2 Deregistration Statement for Persons Registered Pursuant

FR G-2
OMB Number 7100-0011
Approval expires June 30, 2021
Page 1 of 2

Board of Governors of the Federal Reserve System

Deregistration Statement for Persons Registered
Pursuant to Regulation U—FR G-2
For use by Noncorporate Registrants
This deregistration statement is required by law (15 U.S.C. §§
78g and 78w; 12 C.F.R. § 221).

The form must be filed by submitting a Portable Document
Format ("PDF") version to the designated email address
MSD-GSD-Registration@frb.gov.

The Federal Reserve may not conduct or sponsor, and an organization (or a person) is not required to respond to, a collection of
information unless it displays a currently valid OMB control number.

Certificate
I (We), doing business under the name

Name
IRS Identification Number1

hereby certify that I (we) have not, during the preceding six calendar months, had a total of $200,000 or more of credit outstanding secured directly or indirectly by margin stock.
I (We) understand that if I (we), in the future, extend a total of
$200,000 or more during any calendar quarter, or have outstanding

Signature

Date

at any time during a calendar quarter a total of $500,000 or more,
in credit that is secured directly or indirectly by collateral that
includes any margin stock, I (we) shall within 30 calendar days
following the end of such calendar quarter re-register and remain
registered for at least six months with the Board of Governors of
the Federal Reserve System by filing Federal Reserve Form G-1
with the Federal Reserve Bank of the district in which my (our)
principal office is located.
This certification is given in connection with an application for termination of registration pursuant to Section 221.3(b)(2) of Regulation
U of the Board of Governors of the Federal Reserve System.

Signature

Print or Type Name

Print or Type Name

Title

Title

Date

Name of Firm

Area Code / Phone Number

1. A registrant who is an individual is not required to disclose his or her
Social Security number.

Honest, accurate, and timely statements are required by law.
(15 U.S.C. § 78ff; 18 U.S.C. § 1001)
Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time to gather and maintain data in the required form and to review
instructions and complete the information collection. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing
this burden to: Secretary, Board of Governors of the Federal Reserve System, 20th and C Streets, NW, Washington, DC 20551; and to the Office of Management and Budget, Paperwork
Reduction Project (7100-0011), Washington, DC 20503.
06/2018

FR G-2
Page 2 of 2

Board of Governors of the Federal Reserve System

Deregistration Statement for Persons Registered
Pursuant to Regulation U—FR G-2
For use by Corporate Registrants
This deregistration statement is required by law (15 U.S.C. §§
78g and 78w; 12 C.F.R. § 221).

The form must be filed by submitting a Portable Document
Format ("PDF") version to the designated email address
MSD-GSD-Registration@frb.gov.

The Federal Reserve may not conduct or sponsor, and an organization (or a person) is not required to respond to, a collection of
information unless it displays a currently valid OMB control number.

Officer's Certificate
I hereby certify that

Name of Corporation
IRS Identification Number 2

(“Corporation”) has not, during the preceding six calendar
months, had a total of $200,000 or more of credit outstanding
secured directly or indirectly by margin stock.
It is understood that if the Corporation shall, in the future, extend
a total of $200,000 or more during any calendar quarter, or has

Signature of Duly Authorized Officer

outstanding at any time during a calendar quarter a total of
$500,000 or more, in credit that is secured directly or indirectly by
collateral that includes any margin stock, the Corporation shall
within 30 days following the end of such calendar quarter re-register and remain registered for at least six months with the Board
of Governors of the Federal Reserve System by filing Federal
Reserve Form G-1 with the Federal Reserve Bank of the district
in which the principal office of the corporation is located.
This certification is given in connection with an application for termination of registration pursuant to Section 221.3(b)(2) of Regulation
U of the Board of Governors of the Federal Reserve System.

Date

Print or Type Name

Title

Area Code / Phone Number

2. A registrant who is an individual is not required to disclose his or her
Social Security number.

Honest, accurate, and timely statements are required by law.
(15 U.S.C. § 78ff; 18 U.S.C. § 1001)
Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time to gather and maintain data in the required form and to review
instructions and complete the information collection. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing
this burden to: Secretary, Board of Governors of the Federal Reserve System, 20th and C Streets, NW, Washington, DC 20551; and to the Office of Management and Budget, Paperwork
Reduction Project (7100-0011), Washington, DC 20503.
06/2018