UNITED STATES 

SECURITIES AND EXCHANGE COMMISSION

Washington, D. C. 20549

FORM SE 

FORM FOR SUBMISSION OF PAPER FORMAT EXHIBITS

BY EDGAR ELECTRONIC FILERS 

Exact name of registrant as specifi ed in charter Registrant CIK Number

Electronic report, schedule or registration statement SEC fi le number, if available

of which the documents are a part (give period of report) 

S-_______________ ________________________________________

(Series identifi er(s) and names(s), if applicable; add more lines as needed)

C-_______________ ________________________________________

(Class (contract) identifi er(s) and names(s), if applicable; add more lines as needed)

________________________________________________

Report period (if applicable)

________________________________________________

Name of person fi ling this exhibit (if other than the registrant)

Identify the provision of Regulation S-T (§232 of this chapter) under which this exhibit is being fi led in paper (check only one):

____ Rule 201 (Temporary Hardship Exemption)

____ Rule 202 (Continuing Hardship Exemption)

____ Rule 311 (Permitted Paper Exhibit)

SIGNATURES

Filings Made By the Registrant:

The Registrant has duly caused this form to be signed on its behalf by the undersigned, thereunto duly authorized, in the City 

of _________________________________________, State of _______________________________________, 20______________

(Registrant)

By: 

(Name )

(Title)

Filings Made by Person Other Than the Registrant:

After reasonable inquiry and to the best of my knowledge and belief, I certify on _____________________, 20 _____, that the information set forth in this statement is true and complete.

By: 

 (Name)

 (Title)

SEC 2082 (11-11)

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FORM SE GENERAL INSTRUCTIONS 

1. Rules as to Use of Form SE

A. Electronic fi lers must use this form to submit any paper format exhibit under the Securities Act of 1933, the Securities Exchange Act of 1934, the Trust Indenture Act of 1939, or the Investment Company Act of 1940, provided that the submission of such 

exhibit in paper is permitted under Rule 201, 202, or 311 of Regulation S-T (§§ 232.201, 232.202, or 232.311 of this chapter).

B. Electronic fi lers are subject to Regulation S-T (Part 232 of this chapter) and the EDGAR Filer Manual. We direct your attention to the General Rules and Regulations under the Securities Act of 1933, the Securities Exchange Act of 1934, the Trust Indenture 

Act of 1939, the Investment Company Act of 1940, and the electronic fi ling rules and regulations under these Acts.

2. Preparation of Form SE.

Submit in paper format four complete copies of both the Form SE and the exhibit fi led under cover of the Form SE.

3. Filing of Form SE.

A. If you are fi ling the exhibit under a temporary hardship exemption, submit the exhibit and a Form TH (§§239.65, 249.447,

 259.604, 269.10, and 274.404 of this chapter) under cover of this Form SE no later than one business day after the date on which 

the exhibit was to have been fi led electronically. See Rule 201 of Regulation S-T (§232.201 of this chapter).

B. If you are fi ling the exhibit under a continuing hardship exemption under Rule 202 of Regulation S-T (§232.202 of this

chapter), or as allowed by Rule 311 of Regulation S-T (§232.311 of this chapter), you may fi le the exhibit in paper under cover of 

Form SE up to six business days before or on the date of fi ling of the electronic format document to which it relates; you may not 

fi le the exhibit after the fi ling date of the electronic document to which it relates. Exhibits fi led under a continuing hardship exemption must include the legend required by Rule 202(c) (§232.202(c) of this chapter). If you submit the paper exhibit in this manner, 

you will have satisfi ed any requirements that you fi le the exhibit with, provide the document with, or have the document accompany 

the electronic fi ling. This instruction does not affect any requirement that you deliver or furnish the information in the exhibit to 

persons other than the

Commission.

C. Identify the exhibit being fi led. Attach to the Form SE the paper format exhibit and an exhibit index if required by Item 601

of Regulation S-K of this chapter.

4. Signatures.

A. Submit one copy signed by each person on whose behalf you are submitting the form or by that person’s authorized representative. If the form is signed by the authorized representative of a person (other than an executive offi cer or general partner), fi le 

with the form the evidence of the authority of the representative to sign on behalf of such person, except that you may incorporate 

by reference a power of attorney for this purpose that is already on fi le with the Commission.

B. Signatures may be in typed form rather than manual format.