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Form X-17A-5 Focus Report Part IIB OTC Derivates Dealer (SEC2430) Form. This is a Official Federal Forms form and can be use in Securities And Exchange Commission.
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UNITED STATES002 SECURITIES AND EXCHANGE COMMISSION002 Washington, D.C. 20549 FORM X-17A-5 FOCUS REPORT002 (Financial and Operational Combined Uniform Single Report) PART IIB 11OTC DERIVATIVES DEALER OMB APPROVAL OMB Number: 3235-0498 Expires: Estimated average burden hours per response. . . . . . . . 20 (PLEASE READ INSTRUCTIONS BEFORE PREPARING FORM.) THIS REPORT IS BEING FILED PURSUANT TO (Check Applicable Block(s)):1)Rule 17a-1216 2)Rule 17a-1118 3)Other26 13 14(Name of Dealer) (SEC File No.) 20 15(Address of Principal Place of Business (DO NOT USE P.O. Box No.)) (Firm I.D. No.) 2122 23 24(City) (State) (Zip Code) (For Period Beginning (MM/DD/YYYY)) 25NAME AND TELEPHONE NO. OF PERSON TO CONTACT IN REGARD TO THIS REPORT: 30 (Name) (For Period Ending (MM/DD/YYYY)) 31 ((Area Code) - (Telephone No.) NAME(s) OF SUBSIDIARIES OR AFFILIATES CONSOLIDATED IN THIS REPORT: 32 34 36 38 [Does respondent carry its own customer accouCheck here if respondent is filing an audited reOFFICIAL USE 33 35 37 39nts?] Yes 40 N0 41port: 42 EXECUTION: The registrant/dealer submitting this Form and its attachments and the person(s) by whom it is executed represent hereby that all information contained therein is true, correct and complete. It is understood that all required items, statements, and schedules are considered integral parts of this Form and that the submission of any amendment represents that all unamended items, statements and schedules remain true, correct and complete as previously submitted.Dated the day of , MANUAL SIGNATURES OF: 1) (Principal Executive Officer or Managing Partner) 2) (Principal Financial Officer or Partner) 3) (Principal Operations Officer or Partner) ATTENTION 227 Intentional misstatements or omissions of facts constitute Federal Criminal Violations. (See 18 U.S.C. 1001 and 15 U.S.C. 78:f(a)) SEC 2430 () Page 1 of 28 American LegalNet, Inc. www.FormsWorkFlow.com FOR SEC USE ONLY TO BE COMPLETED WITH THE ANNUAL AUDIT REPORT ONLY:002 CERTIFIED PUBLIC ACCOUNTANT whose opinion is contained in this report: 70 ((Name) If Individual, give last, first, middle name) 71 ((Address) DO NOT USE P.O. Box No.) 72 73 74(City) (State) (Zip Code) DO NOT WRITE UNDER THIS LINE FOR SEC USE ONLY WORK LOCATION 50 REPORT DATE (MM/DD/YYYY) 51 DOC. SEQ. NO. 52 CARD 53 SEC 2430 () Page 2 of 28 American LegalNet, Inc. www.FormsWorkFlow.com FINANCIAL AND OPERATIONAL COMBINED UNIFORM SINGLE REPORT PART IIB N 2 100(Name of Dealer) STATEMENT OF FINANCIAL CONDITION FOR OTC DERIVATIVES DEALERS Consolidated 198 99 98 Unconsolidated 199 As of (MM/DD/YYYY) (SEC File No.) ASSETS Assets Allowable003 Non-Allowable Total 1. Cash .............................................................. $ 200003 $ 750002 2.Cash segregated in compliance withfederal and other regulations ...................... 210 760 3.Receivable from broker/dealers andclearing organizations:A.Failed to deliver ..................................... 230003 770 B.Securities borrowed............................... 250003 780002 C.Omnibus accounts ................................ 270003 790002 D.003 Clearing organization ............................ 290 800002 E.Contracts:1. Interest Rate ...................................... 291003 801002 2. Currency & Foreign Exchange ......... 292003 802002 3. Equity ............................................... 293003 803002 4. Commodity ...................................... 294003 804002 5. Other ................................................ 295003 805002 F. Other .................................................... 300 $ 550 810002 4.Receivable from customers:A.Securities accounts:1. Cash and fully secured accounts..... 310 2. Partly secured accounts .................. 320 560002 3. Unsecured accounts ....................... ............................................ 570002 B.Commodity accounts .......................... 330 580002 C.003 Allowance for doubtful accounts ........ ()335 () 590 820002 OMIT PENNIES SEC 2430 () Page 3 of 28 American LegalNet, Inc. www.FormsWorkFlow.com FINANCIAL AND OPERATIONAL COMBINED UNIFORM SINGLE REPORT002 PART IIB002 (Name of Dealer) As of (MM/DD/YYYY) STATEMENT OF FINANCIAL CONDITION FOR OTC DERIVATIVES DEALERS ASSETS (continued) Assets Allowable Non-Allowable Total 5.Receivables from non-customers:A.Cash and fully secured accounts .......... $ 340002 B.Partly secured and unsecured accounts $ 350 $ 600 $ 830 6.Securities purchased under agreementsto resale ........................................................ 360 605 840 7.Securities and spot commodities ownedat market value:A.Bankers acceptances, certificatesof deposit and commercial paper ........ 370002B.003 U.S. and Canadian government002 obligations ............................................ 002 380 C.State and municipal governmentobligations ............................................ 390002 D.003 Corporate obligations .......................... 400002 E.Stocks and warrants ............................ 410002 F.Options ................................................ 420002 G. Arbitrage ............................................. 422002 H.Other securities .................................. 424002 I.Spot commodities ............................. 430 850002 8.Securities owned not readily marketable:A.At cost ........ $ 130 440 610 860002 9.Other investments not readily marketable:A.At cost ........ $ 140002 B.At estimated fair value ....................... 450 620 870002 10.Securities borrowed under subordinationagreements and partners222 individual andcapital securities accounts at marketvalue:A.Exemptedsecurities...... $ 150 B.Other ........... $ 160460 630 880 OMIT PENNIES SEC 2430 () Page 4 of 28 American LegalNet, Inc. www.FormsWorkFlow.com FINANCIAL AND OPERATIONAL COMBINED UNIFORM SINGLE REPORT002 PART IIB002 (Name of Dealer) As of (MM/DD/YYYY) STATEMENT OF FINANCIAL CONDITION FOR OTC DERIVATIVES DEALERS ASSETS (continued) Assets Allowable Non-Allowable Total 11.Secured demand notes - market value ofcollateral:A.Exemptedsecurities ........ $ 170002 B. Other ............... $ 180002 470 640 890 12.Investment in and receivables fromaffiliates, subsidiaries and associatedpartnerships.......................................... 480 670 910 13.Property, furniture, equipment, lease255hold improvements and rights underlease agreements: At cost (net of accumulated depreciationand amortization) ........................................ $ 490 $ 680 $ 920 14.Other Assets:A.Dividends and interest receivable...500 690 B. Free shipments................................002 510 700 C.Loans and advances ......................002 520 710 D. Miscellaneous ................................002 530 720 930 15. TOTAL ASSETS.......002 $ 540 $ 740 $ 940 OMIT PENNIES SEC 2430 () Page 5 of 28 American LegalNet, Inc. www.FormsWorkFlow.com FINANCIAL AND OPERATIONAL COMBINED UNIFORM SINGLE REPORT002 PART IIB002 (Name of Dealer) As of (MM/DD/YYYY) STATEMENT OF FINANCIAL CONDITION FOR OTC DERIVATIVES DEALERS LIABILITIES AND OWNERSHIP EQUITY Liabilities Total 16. Bank loans payable: ....................................................................................................................................................... 17. Securities sold under repurchase agreement ............................................................................................................. 18.Payable to brokers/dealers and clearingorganizations:A. Failed to receive: .................................................................................................................................................... B. Securities loaned: .................................................................................................................................................... C. Omnibus accounts: ................................................................................................................................................ D. Clearing organization: .......................................................................................................................................... E. Other .............................................................................