EX-10.1
from S-1/A
2 pages
Firm Information Otc Equity Symbol Request Form Firm Name: Mpid: Contact Name: Telephone: 5. Is Issuer an SEC Reporting Company? 6. Country of Incorporation: Issue Information Foreign Issue Symbol: 7. Does the Issue Trade on a Foreign Exchange? Name of Foreign Exchange: No Yes, Please Provide Information Below 1. Issue Name: Cusip/Cins Number: 2. Security Description: American Depository Receipt/Shares Isin for Underlying Shares: Common Stock Preferred Stock Seasoned Restricted Shares* Warrants Foreign Ordinary Shares Rights Common Shares Limited Partnership Interests Seasoned Reg S Shares* Shares of Beneficial Interest Units Units of Beneficial Interest Other, Please Describe: 3. Security Class (If Applicable): 4. Expiration Date (If Applicable): * Note : To the Extent That This Security Has Not Been Registered Under the Securities Act of 1933, but Is Nonetheless Publicly Tradeable in the U.S. (Due to Its Being Traded as Part of an Exempt Transaction or Otherwise), a Letter of Tradeability Must Be Submitted With This Otc Equity Symbol Request Form Explaining in Detail the Grounds for Its Public Tradeability. ADR Ratio: Sponsored Unsponsored Depository Bank: REIT Yes, SEC Cik #:: No if US, State of Incorporation: 8. Does the Issuer Have Another Class of Security Listed on a US Exchange? Name of US Exchange: No Yes, Please Provide Information Below Issue Symbol: Depository Bank: Global Depository Receipt/Shares* Isin for Underlying Shares: Gdr Ratio: Sponsored F - 6 Filed With SEC? Yes, Effective Date: No Unsponsored Email: Print Form Page 1 of 2 Otc Equity Symbol Form 03/10
12/34/56
