Trading Notification Form

Security Symbol and Name

Symbols of Covered Securities

Concurrent Offering?

Type of Transaction

Trade Date/Number of Shares/Average Price

Type of Security Offered

Number of Shares Offered

Offering Price

Last Sale before Distribution

Pricing Basis

Pricing Date

SEC Effective Date and Time

Trade Date

Restricted Period

"Actively Traded" Instruction/fields

Commencement Date and Time

Member Firm/CRD

MPID

Non-Member Firm?

Engaged in a Syndicate Covering Transaction/Imposed a Penalty Bid or Entered a Stabilizing Bid

Dates/Aggregate Number of Shares