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SEC 870 (01-22)

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

FORM S-1

REGISTRATION STATEMENT UNDER THE SECURITIES ACT OF 1933

(Exact name of registrant as specified in its charter)

(State or other jurisdiction of incorporation or organization)

(Primary Standard Industrial Classification Code Number)

(I.R.S. Employer Identification Number)

(Address, including zip code, and telephone number,

including area code, of registrant’s principal executive offices)

(Name, address, including zip code, and telephone number,

including area code, of agent for service)

(Approximate date of commencement of proposed sale to the public)

If any of the securities being registered on this Form are to be offered on a delayed or continuous basis pursuant to Rule 415 under the 

Securities Act of 1933 check the following box: 

If this Form is filed to register additional securities for an offering pursuant to Rule 462(b) under the Securities Act, please check the 

following box and list the Securities Act registration statement number of the earlier effective registration statement for the same offering. 

If this Form is a post-effective amendment filed pursuant to Rule 462(c) under the Securities Act, check the following box and list the 

Securities Act registration statement number of the earlier effective registration statement for the same offering. 

If this Form is a post-effective amendment filed pursuant to Rule 462(d) under the Securities Act, check the following box and list the 

Securities Act registration statement number of the earlier effective registration statement for the same offering. 

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, smaller reporting 

company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” 

and "emerging growth company" in Rule 12b-2 of the Exchange Act. 

Large accelerated filer Accelerated filer 

Non-accelerated filer Smaller reporting company 

Emerging growth company

Persons who are to respond to the collection of information contained in this form 

are not required to respond unless the form displays a currently valid OMB control 

number.
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If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying 

with any new or revised financial accounting standards provided pursuant to Section 7(a)(2)(B) of the Securities Act. 

GENERAL INSTRUCTIONS

I. Eligibility Requirements for Use of Form S-1

This Form shall be used for the registration under the Securities Act of 1933 ("Securities Act"); of securities of all registrants for 

which no other form is authorized or prescribed, except that this Form shall not be used for securities of foreign governments or political 

subdivisions thereof or asset-backed securities, as defined in 17 CFR 229.1101(c).

II. Application of General Rules and Regulations

A. Attention is directed to the General Rules and Regulations under the Securities Act, particularly those comprising Regulation

C (17 CFR 230.400 to 230.494) thereunder. That Regulation contains general requirements regarding the preparation and

filing of the registration statement.

B. Attention is directed to Regulation S-K (17 CFR Part 229) for the requirements applicable to the content of the non-financial

statement portions of registration statements under the Securities Act. Where this Form directs the registrant to furnish

information required by Regulation S-K and the item of Regulation S-K so provides, information need only be furnished to

the extent appropriate.

C. A registration statement filed (or submitted for confidential review) under Section 6 of the Securities Act (15 U.S.C. 77f) by an

emerging growth company, defined in Section 2(a)(19) of the Securities Act (15 U.S.C. 77b(a)(19)), prior to an initial public

offering may omit financial information for historical periods otherwise required by Regulation S-X (17 CFR Part 210) as of

the time of filing (or confidential submission) of the registration statement, provided that:

1. The omitted financial information relates to a historical period that the registrant reasonably believes will not be required

to be included in this Form at the time of the contemplated offering; and

2. Prior to the registrant distributing a preliminary prospectus to investors, the registration statement is amended to include

all financial information required by Regulation S-X at the date of the amendment.

III. Exchange Offers

If any of the securities being registered are to be offered in exchange for securities of any other issuer, the prospectus shall also

include the information which would be required by item 11 if the securities of such other issuer were registered on this Form. There shall 

also be included the information concerning such securities of such other issuer which would be called for by Item 9 if such securities 

were being registered. In connection with this instruction, reference is made to Rule 409.

IV. Roll-up Transactions

If the securities to be registered on this Form will be issued in a roll-up transaction as defined in Item 901(c) of Regulation S-K (17

CFR 229.901(c)), attention is directed to the requirements of Form S-4 applicable to roll-up transactions, including, but not limited to, 

General Instruction I.

V. Registration of Additional Securities

With respect to the registration of additional securities for an offering pursuant to Rule 462(b) under the Securities Act, the registrant 

may file a registration statement consisting only of the following: the facing page; a statement that the contents of the earlier registration 

statement, identified by file number, are incorporated by reference; required opinions, consents, and filing fee-related information; 

the signature page; and any price-related information omitted from the earlier registration statement in reliance on Rule 430A that the 

registrant chooses to include in the new registration statement. The information contained in such a Rule 462(b) registration statement 

shall be deemed to be a part of the earlier registration statement as of the date of effectiveness of the Rule 462(b) registration statement. 

Any opinion or consent required in the Rule 462(b) registration statement may be incorporated by reference from the earlier registration 

statement with respect to the offering, if: (i) such opinion or consent expressly provides for such incorporation; and (ii) such opinion 
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relates to the securities registered pursuant to Rule 462(b). See Rule 439(b) under the Securities Act (17 CFR 230.439(b)).

VI. Offerings of Asset-Backed Securities.

The following applies if a registration statement on this Form S-1 is being used to register an offering of asset-backed securities. Terms 

used in this General Instruction VI. have the same meaning as in Item 1101 of Regulation AB (17 CFR 229.1101).

A. Items that may be Omitted. 

Such registrants may omit the information called for by Item 11, Information with Respect to the Registrant. 

B. Substitute Information to be Included. 

In addition to the Items that are otherwise required by this Form, the registrant must furnish in the prospectus the information required 

by Items 1102 through 1120 of Regulation AB (17 CFR 229.1102 through 229.1120). 

C. Signatures.

The registration statement must be signed by the depositor, the depositor’s principal executive officer or officers, principal financial 

officer and controller or principal accounting officer, and by at least a majority of the depositor’s board of directors or persons 

performing similar functions. 

VII. Eligibility to Use Incorporation by Reference

If a registrant meets the following requirements in paragraphs A-F immediately prior to the time of filing a registration statement on 

this Form, it may elect to provide information required by Items 3 through 11 of this Form in accordance with Item 11A and Item 12 

of this Form. Notwithstanding the foregoing, in the financial statements, incorporating by reference or cross-referencing to information 

outside of the financial statements is not permitted unless otherwise specifically permitted or required by the Commission’s rules 

or by U.S. Generally Accepted Accounting Principles or International Financial Reporting Standards as issued by the International 

Accounting Standards Board, whichever is applicable.

A. The registrant is subject to the requirement to file reports pursuant to Section 13 or Section 15(d) of the Securities Exchange Act of 

1934 (“Exchange Act”).

B. The registrant has filed all reports and other materials required to be filed by Sections 13(a), 14, or 15(d) of the Exchange Act 

during the preceding 12 months (or for such shorter period that the registrant was required to file such reports and materials).

C. The registrant has filed an annual report required under Section 13(a) or Section 15(d) of the Exchange Act for its most recently 

completed fiscal year.

D. The registrant is not:

1. And during the past three years neither the registrant nor any of its predecessors was:

(a) A blank check company as defined in Rule 419(a)(2) (§230.419(a)(2));

(b) A shell company, other than a business combination related shell company, each as defined in Rule 405 

(§230.405); or

(c) A registrant for an offering of penny stock as defined in Rule 3a51-1 of the Exchange Act (§240.3a51-1 of this 

chapter).

2. Registering an offering that effectuates a business combination transaction as defined in Rule 165(f)(1) (§230.165(f)(1) 

of this chapter).

E. If a registrant is a successor registrant it shall be deemed to have satisfied conditions A., B., C., and D.2 above if:

1. Its predecessor and it, taken together, do so, provided that the succession was primarily for the purpose of changing 

the state of incorporation of the predecessor or forming a holding company and that the assets and liabilities of the 

successor at the time of succession were substantially the same as those of the predecessor; or

2. All predecessors met the conditions at the time of succession and the registrant has continued to do so since the 

succession.

F. The registrant makes its periodic and current reports filed pursuant to Section 13 or Section 15(d) of the Exchange Act that are 

incorporated by reference pursuant to Item 11A or Item 12 of this Form readily available and accessible on a Web site maintained by 

or for the registrant and containing information about the registrant.
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PART I—INFORMATION REQUIRED IN PROSPECTUS

Item 1. Forepart of the Registration Statement and Outside Front Cover Page of Prospectus.

Set forth in the forepart of the registration statement and on the outside front cover page of the prospectus the information required 

by Item 501 of Regulation S-K (§229.501 of this chapter).

Item 2. Inside Front and Outside Back Cover Pages of Prospectus.

Set forth on the inside front cover page of the prospectus or, where permitted, on the outside back cover page, the information 

required by Item 502 of Regulation S-K (§229.502 of this chapter).

Item 3. Summary Information, Risk Factors and Ratio of Earnings to Fixed Charges.

Furnish the information required by Items 105 and 503 of Regulation S-K (§ 229.105 and § 229.503 of this chapter).

Item 4. Use of Proceeds.

Furnish the information required by Item 504 of Regulation S-K (§229.504 of this chapter).

Item 5. Determination of Offering Price.

Furnish the information required by Item 505 of Regulation S-K (§229.505 of this chapter).

Item 6. Dilution.

Furnish the information required by Item 506 of Regulation S-K (§229.506 of this chapter).

Item 7. Selling Security Holders.

Furnish the information required by Item 507 of Regulation S-K (§229.507 of this chapter).

Item 8. Plan of Distribution.

Furnish the information required by Item 508 of Regulation S-K (§229.508 of this chapter).

Item 9. Description of Securities to be Registered.

Furnish the information required by Item 202 of Regulation S-K (§229.202 of this chapter).

Item 10. Interests of Named Experts and Counsel.

Furnish the information required by Item 509 of Regulation S-K (§229.509 of this chapter).

Item 11. Information with Respect to the Registrant.

Furnish the following information with respect to the registrant:

(a) Information required by Item 101 of Regulation S-K (§229.101 of this chapter), description of business;

(b) Information required by Item 102 of Regulation S-K (§229.102 of this chapter), description of property;

(c) Information required by Item 103 of Regulation S-K (§229.103 of this chapter), legal proceedings;

(d) Where common equity securities are being offered, information required by Item 201 of Regulation S-K (§229.201 of this chapter), 

market price of and dividends on the registrant’s common equity and related stockholder matters;
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(e) Financial statements meeting the requirements of Regulation S-X (17 CFR Part 210) (Schedules required under Regulation S-X

shall be filed as “Financial Statement Schedules” pursuant to Item 15, Exhibits and Financial Statement Schedules, of this Form),

as well as any financial information required by Rule 3-05 and Article 11 of Regulation S-X. A smaller reporting company

may provide the information in Rule 8-04 and 8-05 of Regulation S-X in lieu of the financial information required by Rule 3-05

and Article 11 of Regulation S-X;

(f) Information required by Item 301 of Regulation S-K (§229.301 of this chapter), selected financial data;

(g) Information required by Item 302 of Regulation S-K (§229.302 of this chapter), supplementary financial information;

(h) Information required by Item 303 of Regulation S-K (§229.303 of this chapter), management’s discussion and analysis of financial

condition and results of operations;

(i) Information required by Item 304 of Regulation S-K (§229.304 of this chapter), changes in and disagreements with accountants on

accounting and financial disclosure;

(j) Information required by Item 305 of Regulation S-K (§229.305 of this chapter), quantitative and qualitative disclosures about market

risk.

(k) Information required by Item 401 of Regulation S-K (§229.401 of this chapter), directors and executive officers;

(l) Information required by Item 402 of Regulation S-K (§229.402 of this chapter), executive compensation, and information required

by paragraph (e)(4) of Item 407 of Regulation S-K (§229.407 of this chapter), corporate governance;

(m) Information required by Item 403 of Regulation S-K (§229.403 of this chapter), security ownership of certain beneficial owners

and management; and

(n) Information required by Item 404 of Regulation S-K (§229.404 of this chapter), transactions with related persons, promoters and

certain control persons, and Item 407(a) of Regulation S-K (§229.407(a) of this chapter), corporate governance.

Item 11A. Material Changes.

If the registrant elects to incorporate information by reference pursuant to General Instruction VII., describe any and all material 

changes in the registrant’s affairs which have occurred since the end of the latest fiscal year for which audited financial statements 

were included in the latest Form 10-K and that have not been described in a Form 10-Q or Form 8-K filed under the Exchange Act.

Item 12. Incorporation of Certain Information by Reference.

If the registrant elects to incorporate information by reference pursuant to General Instruction VII.:

(a) It must specifically incorporate by reference into the prospectus contained in the registration statement the following documents by

means of a statement to that effect in the prospectus listing all such documents:

(1) The registrant’s latest annual report on Form 10-K filed pursuant to Section 13(a) or Section 15(d) of the Exchange Act that

contains financial statements for the registrant’s latest fiscal year for which a Form 10-K was required to have been filed; and

(2) All other reports filed pursuant to Section 13(a) or 15(d) of the Exchange Act or proxy or information statements filed

pursuant to Section 14 of the Exchange Act since the end of the fiscal year covered by the annual report referred to in 

paragraph (a)(1) above. 

Note to Item 12(a). Attention is directed to Rule 439 (§230.439) regarding consent to use of material incorporated by reference. 

(b) In addition to the incorporation by reference permitted pursuant to paragraph (a) of this Item, a smaller reporting company,

as defined in Rule 405 (17 CFR 230.405), may elect to incorporate by reference information filed after the effective date of the

registration statement. A smaller reporting company making this election must state in the prospectus contained in the registration

statement that all documents subsequently filed by the registrant pursuant to Sections 13(a), 13(c), 14 or 15(d) of the Exchange Act,

prior to the termination of the offering shall be deemed to be incorporated by reference into the prospectus.

(c)(1) The registrant must state:

(i) That it will provide to each person, including any beneficial owner, to whom a prospectus is delivered, a copy of
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any or all of the reports or documents that have been incorporated by reference in the prospectus contained in the 

registration statement but not delivered with the prospectus;

(ii) That it will provide these reports or documents upon written or oral request;

(iii) That it will provide these reports or documents at no cost to the requester;

(iv) The name, address, telephone number, and e-mail address, if any, to which the request for these reports or

documents must be made; and

(v) The registrant’s Web site address, including the uniform resource locator (URL) where the incorporated reports and

other documents may be accessed.

Note to Item 12(c)(1). If the registrant sends any of the information that is incorporated by reference in the prospectus contained in 

the registration statement to security holders, it also must send any exhibits that are specifically incorporated by reference in that 

information.

(2) The registrant must:

(i) Identify the reports and other information that it files with the SEC; and

(ii) State that the SEC maintains an Internet site that contains reports, proxy and information statements, and other

information regarding issuers that file electronically with the SEC and state the address of that site (http://www.sec.gov).

Item 12A. Disclosure of Commission Position on Indemnification for Securities Act Liabilities.

Furnish the information required by Item 510 of Regulation S-K (§229.510 of this chapter).

PART II—INFORMATION NOT REQUIRED IN PROSPECTUS

Item 13. Other Expenses of Issuance and Distribution.

Furnish the information required by Item 511 of Regulation S-K (§229.511 of this chapter).

Item 14. Indemnification of Directors and Officers.

Furnish the information required by Item 702 of Regulation S-K (§229.702 of this chapter).

Item 15. Recent Sales of Unregistered Securities.

Furnish the information required by Item 701 of Regulation S-K (§229.701 of this chapter).

Item 16. Exhibits and Financial Statement Schedules.

(a) Subject to the rules regarding incorporation by reference, furnish the exhibits as required by Item 601 of Regulation S-K (§229.601

of this chapter).

(b) Furnish the financial statement schedules required by Regulation S-X (17 CFR Part 210) and Item 11(e) of this Form. These schedules

shall be lettered or numbered in the manner described for exhibits in paragraph (a).

(c) Furnish the following information, in substantially the tabular form indicated, as to each type and class of securities being registered 

in the manner required by Item 601(b)(107) of Regulation S-K.
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Calculation of Filing Fee Tables

.............. 

(Form Type)

.............................................................. 

(Exact Name of Registrant as Specified in its Charter)

Table 1: Newly Registered and Carry Forward Securities

Table 2: Fee Offset Claims and Sources

Security 

Type

Security

Class

Title

Fee

Calculation

or Carry

Forward

Rule

Amount

Registered

Proposed

Maximum

Offering

Price Per

Unit

Maximum

Aggregate

Offering

Price

Fee

Rate

Amount of

Registration

Fee

Carry

Forward

Form

Type

Carry

Forward 

File

Number

Carry

Forward

Initial

effective

date

Filing Fee

Previously

Paid In

Connection with

Unsold

Securities

to be

Carried

Forward

Newly Registered Securities

Fees to Be Paid X X X X X X X X

Fees Previously

Paid X X X X X X X

Carry Forward Securities

Carry Forward

Securities X X X X X X X X X

Total Offering Amounts X X

Total Fees Previously Paid X

Total Fee Offsets X

Net Fee Due X

Registrant

or Filer

Name

Form

or

Filing

Type

File

Number

Initial

Filing

Date

Filing

Date

Fee Offset

Claimed

Security

Type

Associated

with Fee

Offset

Claimed

Security

Title

Associated

with Fee

Offset

Claimed

Unsold

Securities

Associated

with Fee

Offset

Claimed

Unsold

Aggregate

Offering

Amount

Associated

with Fee

Offset

Claimed

Fee Paid

with Fee

Offset

Source

Rules 457(b) and 0-11(a)(2)

Fees Offset

Claims X X X X

Fees Offset

Sources X X X X X

Rule 457(p)

Fee Offset

Claims X X X X X X X X X

Fees Offset

Sources X X X X X
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Table 3: Combined Prospectuses

Instructions to the Calculation of Filing Fee Tables and Related Disclosure

(“Instructions”):

1. General Requirements.

A. Applicable Table Requirements.

The “X” designation indicates the information required to be disclosed, as applicable, in tabular format. Add as 

many rows of each table as necessary.

B. Security Types.

i. For securities that are initially being registered, choose a security type permitted to be registered on this form from 

the following list of security types to respond to the applicable table requirement:

a. Asset-Backed Securities;

b. Debt;

c. Debt Convertible into Equity;

d. Equity;

e. Exchange-Traded Vehicle Securities;

f. Face Amount Certificates;

g. Limited Partnership Interests;

h. Mortgage Backed Securities;

i. Non-Convertible Debt;

j. Other; and

k. Unallocated (Universal) Shelf.

ii. When a table requires both security type and title of each class of securities, choose a security type from the list in 

Instruction 1.B.i and provide this information for each unique combination of security type and title of each class of

securities. For example, it would be appropriate to provide the following on separate lines of Table 1:

Equity Class A Preferred Shares

Equity Class B Preferred Shares

Security Type Security Class Title Amount of Securities

Previously Registered

Maximum Aggregate

Offering Price of

Securities

Previously Registered

Form

Type

File

Number

Initial Effective

Date

X X X X X X X
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C. Fee Rate.

For the current fee rate, see https://www.sec.gov/ofm/Article/feeamt.html.

D. Explanations.

If not otherwise explained in response to these instructions, disclose specific details relating to the fee calculation as 

necessary to clarify the information presented in each table, including references to the provisions of Rule 457 (§230.457 of this 

chapter) and any other rule being relied upon. All disclosure these Instructions require that is not specifically required to be presented 

in tabular format must appear in narrative format immediately after the table(s) to which it corresponds. 

2. Table 1: Newly Registered and Carry Forward Securities Table and Related

Disclosure.

A. Newly Registered Securities.

For securities that are initially being registered on this form, provide the following information.

i. Fees to Be Paid and Fees Previously Paid.

a. Fees to Be Paid.

Provide the information Table 1 requires under the heading “Newly Registered Securities” for the line item 

“Fees to Be Paid” for securities to be registered for which filing fees have not already been paid in connection with 

the initial filing of this form or a pre-effective amendment.

b. Fees Previously Paid.

Provide the information Table 1 requires under the heading “Newly Registered Securities” for the line item 

“Fees Previously Paid” for securities to be registered for which filing fees have already been paid in connection with 

the initial filing of this form or a pre-effective amendment.

ii. Fee Calculation or Carry Forward Rules.

a. Rule 457(a).

For a fee calculated as specified in Rule 457(a) (§230.457(a) of this chapter), enter “457(a)”.

b. Rule 457(f).

For a fee calculated as specified in Rule 457(f) (§230.457(f) of this chapter), enter “457(a)”, “457(o)” or 

“Other”, as applicable. 

Separately disclose the amount and value of securities to be received by the registrant or cancelled upon the issuance of 

securities registered on this Form, and explain how the value was calculated in accordance with Rule 457(f)(1) and (2), as applicable. 

The explanation must include the value per share of the securities to be received by the registrant or cancelled upon the issuance 

of securities registered on this Form. Also disclose any amount of cash to be paid by the registrant in connection with the 

exchange or other transaction, and any amount of cash to be received by the registrant in connection with the exchange or other 

transaction. In accordance with Rule 457(f)(3), to determine the maximum aggregate offering price for such a transaction, the 

registrant should deduct any amount of cash to be paid by the registrant in connection with the exchange or other transaction from, 

and add any amount of cash to be received by the registrant in connection with the exchange or other transaction to, the value of 

the securities to be received or cancelled as calculated in accordance with Rule 457(f)(1) and (2), as applicable. Omit from the table 

the maximum offering price per unit.

c. Rule 457(o).

If relying on Rule 457(o) under the Securities Act (§230.457(o) of this chapter) to register securities on this 

Form by maximum aggregate offering price, enter “457(o)”. You may omit from any such row the Amount Registered and the 

Proposed Maximum Offering Price Per Unit.
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 d. Rule 457(u).

If an offering of an indeterminate amount of exchange-traded vehicle securities is being registered, enter 

“457(u)”.

Separately, state that the registration statement covers an indeterminate amount of securities to be offered or sold and that 

the filing fee will be calculated and paid in accordance with Rule 456(d) and Rule 457(u) (§230.456(d) and § 230.457(u) of this 

chapter).

 e. Other.

If relying on a rule other than Rule 457(a), (f), (o), or (u), enter “Other”.

 iii. Other Tabular Information.

 Provide the following information in the table for each unique combination of security type and title of each class of 

securities to be registered as applicable:

 a. The security type of the class of securities to be registered;

 b. The title of the class of securities to be registered;

 c. The amount of securities being registered expressed in terms of the number of securities, proposed maximum 

offering price per unit and resulting proposed maximum aggregate offering price, or, if the related filing fee is calculated in reliance 

on Rule 457(o), the proposed maximum aggregate offering price;

 d. The fee rate; and

 e. The registration fee.

iv. Pre-Effective Amendments.

If a pre-effective amendment is filed to concurrently (i) increase the amount of securities of one or more registered classes or 

add one or more new classes of securities; and (ii) decrease the amount of securities of one or more registered classes, a registrant 

that did not rely on Rule 457(o) to calculate the filing fee due for the initial filing or latest pre-effective amendment to such filing 

may recalculate the total filing fee due for the registration statement in its entirety and claim an offset pursuant to Rule 457(b) in the 

amount of the filing fee previously paid in connection with the registration statement. This recalculation procedure is not available, 

however, if a pre-effective amendment is filed only to increase the amount of securities of one or more registered classes or add one 

or more new classes. A pre-effective amendment that uses this recalculation procedure must include the revised offering amounts 

as securities to be registered for which filing fees have not already been paid in connection with the initial filing of this form or a 

pre-effective amendment for purposes of Table 1. If you use this recalculation procedure, separately disclose that you are 

using it and expressly reference this Instruction 2.A.iv. 

 B. Carry Forward Securities.

If relying on Rule 415(a)(6) under the Securities Act (§230.415(a)(6) of this chapter) to carry forward to this registration 

statement unsold securities from an earlier registration statement, enter “415(a)(6)” in the table and provide, in a separate row for 

each registration statement from which securities are to be carried forward, and for each unique combination of security type and 

title of each class of securities to be carried forward, the following information:

 i. The security type of the class of securities to be carried forward;

 ii. The title of the class of securities to be carried forward;

 iii. The amount of securities being carried forward expressed in terms of the number of securities (under the 

column heading “Amount Registered”) and the amount of the maximum aggregate offering price, as specified in the fee table of the 

earlier filing, associated with those securities (under the column heading “Maximum Aggregate Offering Price”) or, if the related 

filing fee was calculated in reliance on Rule 457(o), the amount of securities carried forward expressed in terms of the maximum 
11

aggregate offering price (under the column heading “Maximum Aggregate Offering Price”);

iv. The form type, file number, and initial effective date of the earlier registration statement from which the

securities are to be carried forward; 

and

v. The filing fee previously paid in connection with the registration of the securities to be carried forward.

C. Totals.

i. Total Offering Amounts.

Provide the sum of the maximum aggregate offering price for both the newly registered and carry forward 

securities and the aggregate registration fee for the newly registered securities.

ii. Total Fees Previously Paid.

Provide the aggregate of registration fees previously paid for the newly registered securities.

iii. Total Fee Offsets.

Provide the aggregate of the fee offsets that are claimed in Table 2 pursuant to Instruction 3.

iv. Net Fee Due

Provide the difference between (a) the aggregate registration fee for the newly registered securities from 

the Total Offering Amounts row; and (b) the sum of (i) the aggregate of registration fees previously paid for the newly registered 

securities from the Total Fees Previously Paid row; and (ii) the aggregate fee offsets claimed from the Total Fee Offsets row. 

3. Table 2: Fee Offset Claims and Sources.

A. Terminology.

For purposes of this Instruction 3 and Table 2, the term “submission” means any (i) initial filing of, or amendment (pre-effective 

or post-effective), to a fee-bearing document; or (ii) fee-bearing form of prospectus filed under Rule 424 under the Securities Act 

(§230.424 of this chapter), in all cases that was accompanied by a contemporaneous fee payment. For purposes of these instructions

to Table 2, a contemporaneous fee payment is the payment of a required fee that is satisfied through the actual transfer of funds, and

does not include any amount of a required fee satisfied through a claimed fee offset. Instructions 3.B.ii and 3.C.ii require a filer that

claims a fee offset under Rule 457(b) or (p) under the Securities Act (§230.457(b) or (p) of this chapter) or Rule 0-11(a)(2) under

the Exchange Act (§240.0-11(a)(2) of this chapter) to identify previous submissions with contemporaneous fee payments that are

the original source to which the fee offsets claimed on this filing can be traced. See Instruction 3.D for an example.

B. Rules 457(b) and 0-11(a)(2).

If relying on Rule 457(b) under the Securities Act (§230.457(b) of this chapter) or Rule 0-11(a)(2) under the Exchange Act 

(§240.0-11(a)(2) of this chapter) to offset some or all of the filing fee due on this registration statement by amounts paid in

connection with earlier filings (other than this Form S-1 unless pursuant to Instruction 2.A.iv) relating to the same transaction,

provide the following information:

i. Fee Offset Claims.

For each earlier filed Securities Act registration statement or Exchange Act document relating to the same transaction from 

which a fee offset is being claimed, provide the information that Table 2 requires under the heading “Rules 457(b) and 0-11(a)(2)” 

for the line item “Fee Offset Claims”. The “Fee Offset Claimed” column requires the dollar amount of the previously paid filing 

fee to be offset against the currently due fee.

Note to Instruction 3.B.i.

If claiming an offset from a Securities Act registration statement, provide a detailed explanation of the basis for the claimed 
12

offset.

ii. Fee Offset Sources.

With respect to amounts claimed as an offset under Rule 457(b) or Rule 0-11(a)(2), identify those submissions with 

contemporaneous fee payments that are the original source to which those amounts can be traced. For each submission identified, 

provide the information that Table 2 requires under the heading “Rules 457(b) and 0-11(a)(2)” for the line item “Fee Offset Sources”. 

The “Fee Paid with Fee Offset Source” column requires the dollar amount of the contemporaneous fee payment made with respect 

to each identified submission that is the source of the fee offset claimed pursuant to Rule 457(b) or 0-11(a)(2).

C. Rule 457(p).

If relying on Rule 457(p) under the Securities Act (§230.457(p) of this chapter) to offset some or all of the filing fee due on this 

registration statement with the filing fee previously paid for unsold securities under an earlier filed registration statement, provide 

the following information:

i. Fee Offset Claims.

For each such earlier filed registration statement from which the registrant is claiming a filing fee offset, provide the information 

Table 2 requires under the heading “Rule 457(p)” for the line item “Fee Offset Claims”. The “Fee Offset Claimed” column requires 

the dollar amount of the previously paid filing fee to be offset against the currently due fee.

Notes to Instruction 3.C.i.

1. Provide a statement that the registrant has either withdrawn each prior registration statement or has terminated or completed any 

offering that included the unsold securities under the prior registration statements.

2. If you were not the registrant under the earlier registration statements, entering information under the heading “Rule 457(p)” 

pursuant to Instruction 3.C.i affirms that you are that registrant’s successor, majority-owned subsidiary, or parent owning more 

than 50% of the registrant’s outstanding voting securities eligible to claim a filing fee offset. See the definitions of “successor” and 

“majority-owned subsidiary” in Rule 405 under the Securities Act (§230.405 of this chapter).

ii. Fee Offset Sources.

With respect to amounts claimed as an offset under Rule 457(p), identify those submissions with contemporaneous fee payments 

that are the original source to which those amounts can be traced. For each submission identified, provide the information Table 2 

requires under the heading “Rule 457(p)” for the line item “Fee Offset Sources”. The “Fee Paid with Fee Offset Source” column 

requires the dollar amount of the contemporaneous fee payment made with respect to each identified submission that is the source 

of the fee offset claimed pursuant to Rule 457(p).

D. Fee Offset Source Submission Identification Example.

A filer:

• Initially files a registration statement on Form S-1 on 1/15/20X1 (assigned file number 333-123456) with a fee payment of 

$10,000;

• Files pre-effective amendment number 1 to the Form S-1 (333-123456) on 2/15/20X1 with a fee payment of $15,000 and 

the registration statement goes effective on 2/20/20X1;

• Initially files a registration statement on Form S-1 on 1/15/20X4 (assigned file number 333-123467) with a fee payment of 

$25,000 and relies on Rule 457(p) to claim an offset of $10,000 related to the unsold securities registered on the previously filed 

Form S-1 (333-123456) and apply it to the $35,000 filing fee due and the registration statement goes effective on 2/15/20X4.

• Initially files a registration statement on Form S-1 (assigned file number 333-123478) on 1/15/20X7 with a fee payment 

of $15,000 and relies on Rule 457(p) to claim an offset of $30,000 related to the unsold securities registered on the most recently 

effective Form S-1 (333-123467) filed on 1/15/20X4 and apply it to the $45,000 filing fee due. 

For the registration statement on Form S-1 with file number 333-123478 filed on 1/15/20X7, the filer can satisfy the submission 

identification requirement when it claims the $30,000 fee offset from the Form S-1 (333-123467) filed on 1/15/20X4 by referencing 

any combination of the Form S-1 (333-123467) filed on 1/15/20X4, the pre-effective amendment to the Form S-1 (333-123456) filed 
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on 2/15/20X1 or the initial filing of the Form S-1 (333-123456) on 1/15/20X1 in relation to which contemporaneous fee payments 

were made equal to $30,000. 

One example could be: 

• the Form S-1 (333-123467) filed on 1/15/20X4 in relation to the payment of $25,000 made with that submission; and

• the pre-effective amendment to the Form S-1 (333-123456) filed on 2/15/20X1 in relation to the payment of $5,000 out of

the payment of $15,000 made with that submission (it would not matter if the filer cited to this pre-effective amendment and/or the 

initial submission of this Form S-1 (333-123456) on 1/15/20X1 as long as singly or together they were cited as relating to a total 

of $5,000 in this example).

In this example, the filer could not satisfy the submission identification requirement solely by citing to the Form S-1 (333-123467) 

filed on 1/15/20X4 because even though the offset claimed and available from that filing was $30,000, the contemporaneous fee 

payment made with that filing ($25,000) was less than the offset being claimed. As a result, the filer must also identify a prior 

submission or submissions with an aggregate of contemporaneous fee payment(s) of $5,000 as the original source(s) to which the 

rest of the claimed offset can be traced.

4. Table 3: Combined Prospectuses.

If this Form includes a combined prospectus pursuant to Rule 429 under the Securities Act of 1933 (§230.429 of this chapter), 

provide the information that Table 3 requires for each earlier effective registration statement that registered securities that may be 

offered and sold using the combined prospectus. Include a separate row for each unique combination of security type and title of each 

class of those securities. The amount of securities previously registered that may be offered and sold using the combined prospectus 

must be expressed in terms of the number of securities (under column heading “Amount of Securities Previously Registered”), or, 

if the related filing fee was calculated in reliance on Rule 457(o), must be expressed in terms of the maximum aggregate offering 

price (under column heading “Maximum Aggregate Offering Price of Securities Previously Registered”).

Note to Instruction 4.

Table 1 should not include the securities registered on an earlier effective registration statement that may be offered and sold using 

the combined prospectus under Rule 429.

Item 17. Undertakings.

Furnish the undertakings required by Item 512 of Regulation S-K (§229.512 of this chapter).

SIGNATURES

Pursuant to the requirements of the Securities Act of 1933, the registrant has duly caused this registration statement to be signed 

on its behalf by the undersigned, thereunto duly authorized in the City of ______________________________________, 

State of ___________________________, on__________________________ , 20___.

(Registrant)

By (Signature and Title)

Pursuant to the requirements of the Securities Act of 1933, this registration statement has been signed by the following persons in 

the capacities and on the dates indicated.

 (Signature)

 (Title)

 (Date)
14

Instructions.

1. The registration statement shall be signed by the registrant, its principal executive officer or officers, its principal financial officer, 

its controller or principal accounting officer and by at least a majority of the board of directors or persons performing similar 

functions. If the registrant is a foreign person, the registration statement shall also be signed by its authorized representative in the 

United States. Where the registrant is a limited partnership, the registration statement shall be signed by a majority of the board of 

directors of any corporate general partner signing the registration statement.

2. The name of each person who signs the registration statement shall be typed or printed beneath his signature. Any person who 

occupies more than one of the specified positions shall indicate each capacity in which he signs the registration statement. Attention 

is directed to Rule 402 concerning manual signatures and to Item 601 of Regulation S-K concerning signatures pursuant to powers 

of attorney.

INSTRUCTIONS AS TO SUMMARY PROSPECTUSES

1. A summary prospectus used pursuant to Rule 431 (§230.431 of this chapter), shall at the time of its use contain much of the 

information specified below as is then included in the registration statement. All other information and documents contained in the 

registration statement may be omitted.

(a) As to Item 1, the aggregate offering price to the public, the aggregate underwriting discounts and commissions and the offering 

price per unit to the public;

(b) As to Item 4, a brief statement of the principal purposes for which the proceeds are to be used;

(c) As to Item 7, a statement as to the amount of the offering, if any, to be made for the account of security holders;

(d) As to Item 8, the name of the managing underwriter or underwriters and a brief statement as to the nature of the underwriter’s 

obligation to take the securities; if any securities to be registered are to be offered otherwise than through underwriters, a brief 

statement as to the manner of distribution; and, if securities are to be offered otherwise than for cash. a brief statement as to 

the general purposes of the distribution, the basis upon which the securities are to be offered, the amount of compensation 

and other expenses of distribution, and by whom they are to be borne;

(e) As to Item 9, a brief statement as to dividend rights, voting rights, conversion rights, interest, maturity;

(f) As to Item 11, a brief statement of the general character of the business done and intended to be done, the selected financial 

data (Item 301 of Regulation S-K (§229.301 of this chapter)) and a brief statement of the nature and present status of any 

material pending legal proceedings; and

(g) A tabular presentation of notes payable, long term debt, deferred credits, minority interests, if material, and the equity section 

of the latest balance sheet filed, as may be appropriate.

2. The summary prospectus shall not contain a summary or condensation of any other required financial information except as provided 

above.

3. Where securities being registered are to be offered in exchange for securities of any other issuer, the summary prospectus also shall 

contain that information as to Items 9 and 11 specified in paragraphs (e) and (f) above which would be required if the securities of 

such other issuer were registered on this Form.

4. The Commission may, upon the request of the registrant, and where consistent with the protection of investors, permit the omission of 

any of the information herein required or the furnishing in substitution therefor of appropriate information of comparable character. 

The Commission may also require the inclusion of other information in addition to, or in substitution for, the information herein 

required in any case where such information is necessary or appropriate for the protection of investors.