UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

FORM N-17f-2

Certificate of Accounting of Securities and Similar 

Investments in the Custody of

Management Investment Companies 

Pursuant to Rule 17f-2 [17 CFR 270.17f-2]

INSTRUCTIONS

This Form must be completed by investment companies that have custody of securities or similar investments. 

Investment Company

1. All items must be completed by the investment company. 

2. Give this Form to the independent public accountant who, in compliance with Rule 17f-2 under the Act and applicable state law, examines 

securities and similar investments in the custody of the investment company. 

Accountant

3. Submit this Form to the Securities and Exchange Commission and appropriate state securities administrators when filing the certificate of

accounting required by Rule 17f-2 under the Act and applicable state law. File the original and one copy with the Securities and Exchange 

Commission’s principal office in Washington, D.C., one copy with the regional office for the region in which the investment company’s

principal business operations are conducted, and one copy with the appropriate state administrator(s), if applicable. 

THIS FORM MUST BE GIVEN TO YOUR INDEPENDENT PUBLIC ACCOUNTANT

SEC 2198 (04-09)

OMB APPROVAL 

OMB Number: 3235-0360 

Expires: December 31, 2026 

Estimated average burden 

hours per response 2.0 

1. Investment Company Act File Number: 

811- 

Date examination completed: 

2. State identification Number: 

AL AK AZ AR CA CO

CT DE DC FL GA HI 

ID IL IN IA KS KY 

LA ME MD MA MI MN

MS MO MT NE NV NH

NJ NM NY NC ND OH

OK OR PA RI SC SD

TN TX UT VT VA WA 

WV WI WY PUERTO RICO 

Other (specify): 

3. Exact name of investment company as specified in registration statement: 

4. Address of principal executive office (number, street, city, state, zip code): 
SEC’s Collection of Information

An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently 

valid OMB control number. Filing of Form N-17f-2 is mandatory for an investment company that has custody of securities or similar 

investments. Rule 17f-2 under section 17(f) of the Investment Company Act of 1940 requires the investment company to retain an independent 

public accountant to verify the company’s securities and similar investments by actual examination three times during each fiscal year. The 

accountant must prepare a certificate stating that the examination has occurred and describing the examination, and must transmit the certificate 

to the Commission with Form N-17f-2 as a cover sheet. The Commission uses the Form to ensure that the certificate is properly attributed to

the investment company. The Commission estimates that the burden of completing Form N-17f-2 is approximately 1.0 hours per filing. Any 

member of the public may direct to the Commission any comments concerning the accuracy of the burden estimate of this Form, and any 

suggestions for reducing this burden. This collection of information has been reviewed by the Office of Management and Budget in accordance 

with the clearance requirements of 44 U.S.C. § 3507. Responses to this collection of information will not be kept confidential. 

2