Payment Form - Interpretative Request Fee
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Payment Form - Interpretative Request Fee Form. This is a Official Federal Forms form and can be use in General Forms NASDAQ.
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The NASDAQ Stock Market®
Payment Form:
Interpretative Request Fee
Interpretation requests must be submitted electronically using the NASDAQ OMX Listing Center.
Pursuant to Rule 5602, all companies submitting requests for interpretations of The NASDAQ Stock
Market listing rules must submit a $15,000 non-refundable fee with their requests. All fees are payable
to The NASDAQ Stock Market LLC.
Please contact Listing Qualifications at +1 301 978 8008 with any questions regarding this process or
with general questions regarding NASDAQ's Listing Rules.
Payment By Wire: The company may remit its fees by wire. Please use the following instructions and
include the specific reference information provided below when transmitting your payment. Submission of
this form is not required.
By Federal Reserve Wire
The NASDAQ Stock Market LLC
Bank Name:
Wachovia Bank, N.A.
Bank Address:
12 East 49th Street
Bank Address:
New York, NY 10017
SWIFT Number:
PNBPUS3NNYC
ABA Number:
031201467
Beneficiary:
NASDAQ
Account Number:
2000031405177
Reference:
Provide company name,
symbol and note that the fees are for an
interpretative request.
By American Clearing House
The NASDAQ Stock Market LLC
Bank Name:
Wachovia Bank, N.A.
Bank Address:
12 East 49th Street
Bank Address:
New York, NY 10017
SWIFT Number:
PNBPUS3NNYC
ABA Number:
026012881
Beneficiary:
NASDAQ
Account Number:
2000031405177
Reference:
Provide company name,
symbol and note that the fees are for an
interpretative request.
Payment By Check: All checks must be sent under separate cover to the address provided below.
Please complete this form and submit it with your payment.
COMPANY NAME
ADDRESS
ADDRESS
REMITTER NAME
(IF NOT THE SAME AS THE COMPANY)
CHECK ENCLOSED IN THE AMOUNT OF $
CHECK NO.
DATE OF LETTER REQUESTING AN INTERPRETATION
Please mail this form and your payment by courier/overnight to:
The NASDAQ Stock Market LLC
Listing Qualifications
Lockbox 90200
c/o Wachovia Bank, N.A.
401 Market Street
Philadelphia, PA 19106
©September 2011, The NASDAQ OMX Group, Inc. All rights reserved. The NASDAQ Stock and NASDAQ are
registered trademarks of The NASDAQ OMX Group, Inc.
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