# EDGAR Filing Document

**Accession Number:** 0001251567
**File Stem:** 0001104659-23-017601
**Filing Date:** 2023-2
**Character Count:** 20068
**Document Hash:** c6b4eb9ac22dd26e32d0d715d336fa25
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001104659-23-017601.hdr.sgml**: 20230209

**ACCESSION NUMBER**: 0001104659-23-017601

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20230207

**FILED AS OF DATE**: 20230209

**DATE AS OF CHANGE**: 20230209

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** WYNNEFIELD PARTNERS SMALL CAP VALUE LP
- **CENTRAL INDEX KEY:** 0000899083
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-34719
- **FILM NUMBER:** 23606554

**BUSINESS ADDRESS:**
- **STREET 1:** 450 SEVENTH AVENUE
- **STREET 2:** SUITE 509
- **CITY:** NEW YORK
- **STATE:** NY
- **ZIP:** 10123
- **BUSINESS PHONE:** 212-760-0814

**MAIL ADDRESS:**
- **STREET 1:** 450 SEVENTH AVENUE
- **STREET 2:** SUITE 509
- **CITY:** NEW YORK
- **STATE:** NY
- **ZIP:** 10123
**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** OBUS NELSON
- **CENTRAL INDEX KEY:** 0001017043

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-34719
- **FILM NUMBER:** 23606548
**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** WYNNEFIELD SMALL CAP VALUE OFFSHORE FUND LTD
- **CENTRAL INDEX KEY:** 0001030806

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-34719
- **FILM NUMBER:** 23606552

**BUSINESS ADDRESS:**
- **STREET 1:** 450 SEVENTH AVE
- **STREET 2:** STE 509
- **CITY:** NEW YORK
- **STATE:** NY
- **ZIP:** 10123
- **BUSINESS PHONE:** 2127600814

**MAIL ADDRESS:**
- **STREET 1:** 450 SEVENTH AVE
- **STREET 2:** STE 509
- **CITY:** NEW YORK
- **STATE:** NY
- **ZIP:** 10123
**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** WYNNEFIELD CAPITAL MANAGEMENT LLC
- **CENTRAL INDEX KEY:** 0001056835

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-34719
- **FILM NUMBER:** 23606551

**BUSINESS ADDRESS:**
- **STREET 1:** 450 SEVENTH AVE
- **STREET 2:** STE 509
- **CITY:** NEW YORK
- **STATE:** NY
- **ZIP:** 10123
- **BUSINESS PHONE:** 2127600814

**MAIL ADDRESS:**
- **STREET 1:** 450 SEVENTH AVE
- **STREET 2:** STE 509
- **CITY:** NEW YORK
- **STATE:** NY
- **ZIP:** 10123
**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** WYNNEFIELD PARTNERS SMALL CAP VALUE LP I
- **CENTRAL INDEX KEY:** 0001251565
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-34719
- **FILM NUMBER:** 23606553

**BUSINESS ADDRESS:**
- **STREET 1:** 450 SEVENTH AVENUE
- **STREET 2:** SUITE 509
- **CITY:** NEW YORK
- **STATE:** NY
- **ZIP:** 10123
- **BUSINESS PHONE:** 212-760-0814

**MAIL ADDRESS:**
- **STREET 1:** 450 SEVENTH AVENUE
- **STREET 2:** SUITE 509
- **CITY:** NEW YORK
- **STATE:** NY
- **ZIP:** 10123
**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** WYNNEFIELD CAPITAL INC
- **CENTRAL INDEX KEY:** 0001251567
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-34719
- **FILM NUMBER:** 23606550

**BUSINESS ADDRESS:**
- **STREET 1:** 450 SEVENTH AVE
- **STREET 2:** STE 509
- **CITY:** NEW YORK
- **STATE:** NY
- **ZIP:** 10123
- **BUSINESS PHONE:** 212-760-0814

**MAIL ADDRESS:**
- **STREET 1:** 450 SEVENTH AVE
- **STREET 2:** STE 509
- **CITY:** NEW YORK
- **STATE:** NY
- **ZIP:** 10123
**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** LANDES JOSHUA
- **CENTRAL INDEX KEY:** 0001251568
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-34719
- **FILM NUMBER:** 23606547
**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Wynnefield Capital, Inc. Profit Sharing Plan
- **CENTRAL INDEX KEY:** 0001289453
- **STATE OF INCORPORATION:** NY

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-34719
- **FILM NUMBER:** 23606549

**BUSINESS ADDRESS:**
- **STREET 1:** 450 SEVENTH AVENUE
- **STREET 2:** SUITE 509
- **CITY:** NEW YORK
- **STATE:** NY
- **ZIP:** 10123
- **BUSINESS PHONE:** 212-760-0278

**MAIL ADDRESS:**
- **STREET 1:** 450 SEVENTH AVENUE
- **STREET 2:** SUITE 509
- **CITY:** NEW YORK
- **STATE:** NY
- **ZIP:** 10123
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** S&W Seed Co
- **CENTRAL INDEX KEY:** 0001477246
- **STANDARD INDUSTRIAL CLASSIFICATION:** AGRICULTURE PRODUCTION - CROPS [0100]
- **IRS NUMBER:** 271275784
- **STATE OF INCORPORATION:** NV
- **FISCAL YEAR END:** 0630

**BUSINESS ADDRESS:**
- **STREET 1:** 2101 KEN PRATT BLVD.
- **STREET 2:** SUITE 201
- **CITY:** LONGMONT
- **STATE:** CO
- **ZIP:** 80501
- **BUSINESS PHONE:** (720) 506-9191

**MAIL ADDRESS:**
- **STREET 1:** 2101 KEN PRATT BLVD.
- **STREET 2:** SUITE 201
- **CITY:** LONGMONT
- **STATE:** CO
- **ZIP:** 80501

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 4

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

[x] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

[ ] Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>WYNNEFIELD PARTNERS SMALL CAP VALUE LP<br><sub>(Last) (First) (Middle)</sub><br>450 SEVENTH AVENUE<br>SUITE 509<br><sub>(Street)</sub><br>NEW YORK, NY 10123<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-02-07 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [X] 10% Owner<br>[ ] Officer (give title below) [ ] Other (specify below)<br>_ _ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>S&W Seed Co [ SANW ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[ ] Form filed by One Reporting Person<br>[X] Form filed by More than One Reporting Person |

---

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>WYNNEFIELD PARTNERS SMALL CAP VALUE LP I<br><sub>(Last) (First) (Middle)</sub><br>450 SEVENTH AVENUE<br>SUITE 509<br><sub>(Street)</sub><br>NEW YORK, NY 10123<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-02-07 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [X] 10% Owner<br>[ ] Officer (give title below) [ ] Other (specify below)<br>_ _ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>S&W Seed Co [ SANW ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[ ] Form filed by One Reporting Person<br>[X] Form filed by More than One Reporting Person |

---

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>WYNNEFIELD SMALL CAP VALUE OFFSHORE FUND LTD<br><sub>(Last) (First) (Middle)</sub><br>450 SEVENTH AVENUE<br>SUITE 509<br><sub>(Street)</sub><br>NEW YORK, NY 10123<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-02-07 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [X] 10% Owner<br>[ ] Officer (give title below) [ ] Other (specify below)<br>_ _ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>S&W Seed Co [ SANW ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[ ] Form filed by One Reporting Person<br>[X] Form filed by More than One Reporting Person |

---

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>WYNNEFIELD CAPITAL MANAGEMENT LLC<br><sub>(Last) (First) (Middle)</sub><br>450 SEVENTH AVENUE<br>SUITE 509<br><sub>(Street)</sub><br>NEW YORK, NY 10123<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-02-07 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [X] 10% Owner<br>[ ] Officer (give title below) [ ] Other (specify below)<br>_ _ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>S&W Seed Co [ SANW ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[ ] Form filed by One Reporting Person<br>[X] Form filed by More than One Reporting Person |

---

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>WYNNEFIELD CAPITAL INC<br><sub>(Last) (First) (Middle)</sub><br>450 SEVENTH AVENUE<br>SUITE 509<br><sub>(Street)</sub><br>NEW YORK, NY 10123<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-02-07 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [X] 10% Owner<br>[ ] Officer (give title below) [ ] Other (specify below)<br>_ _ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>S&W Seed Co [ SANW ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[ ] Form filed by One Reporting Person<br>[X] Form filed by More than One Reporting Person |

---

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>Wynnefield Capital, Inc. Profit Sharing Plan<br><sub>(Last) (First) (Middle)</sub><br>450 SEVENTH AVENUE<br>SUITE 509<br><sub>(Street)</sub><br>NEW YORK, NY 10123<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-02-07 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [X] 10% Owner<br>[ ] Officer (give title below) [ ] Other (specify below)<br>_ _ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>S&W Seed Co [ SANW ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[ ] Form filed by One Reporting Person<br>[X] Form filed by More than One Reporting Person |

---

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>OBUS NELSON<br><sub>(Last) (First) (Middle)</sub><br>450 SEVENTH AVENUE<br>SUITE 509<br><sub>(Street)</sub><br>NEW YORK, NY 10123<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-02-07 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [X] 10% Owner<br>[ ] Officer (give title below) [ ] Other (specify below)<br>_ _ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>S&W Seed Co [ SANW ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[ ] Form filed by One Reporting Person<br>[X] Form filed by More than One Reporting Person |

---

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>LANDES JOSHUA<br><sub>(Last) (First) (Middle)</sub><br>450 SEVENTH AVENUE<br>SUITE 509<br><sub>(Street)</sub><br>NEW YORK, NY 10123<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-02-07 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [X] 10% Owner<br>[ ] Officer (give title below) [ ] Other (specify below)<br>_ _ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>S&W Seed Co [ SANW ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[ ] Form filed by One Reporting Person<br>[X] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| Common Stock, par value $0.0001 per share | 2023-02-07 |  | S |  | 119244 | D | $1.7115 | 1336741 | D<sup>(1)</sup> |  |
| Common Stock, par value $0.0001 per share | 2023-02-07 |  | S |  | 260756 | D | $1.7115 | 2776209 | I | See footnotes<sup>(2)(3)(4)</sup> |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |

---

### Footnotes:

(1) The Reporting Person directly beneficially owns 1,336,741 shares of common stock, $0.0001 par value per share ("Common Stock") of S&W Seed Company (the "Issuer"). Wynnefield Capital Management, LLC, as the sole general partner of the Reporting Person, has an indirect beneficial ownership interest in the shares of Common Stock that the Reporting Person directly beneficially owns. Nelson Obus and Joshua Landes, as co-managing members of Wynnefield Capital Management, LLC, have an indirect beneficial ownership interest in the shares of Common Stock that the Reporting Person directly beneficially owns.

(2) The Reporting Person has an indirect beneficial ownership interest in 2,104,556 shares of Common Stock, which are directly beneficially owned by Wynnefield Partners Small Cap Value, L.P. I, as members of a group under Section 13(d) of the Securities Exchange Act of 1934, as amended (the "Exchange Act"). Wynnefield Partners Small Cap Value, L.P. I, which maintains offices at the same address as the Reporting Person, is filing this statement jointly with the Reporting Person. Wynnefield Capital Management, LLC, as the sole general partner of Wynnefield Partners Small Cap Value, L.P. I, has an indirect beneficial ownership interest in the shares of Common Stock that Wynnefield Partners Small Cap Value L.P. I directly beneficially owns. Nelson Obus and Joshua Landes, as co-managing members of Wynnefield Capital Management, LLC, have an indirect beneficial ownership interest in the shares of Common Stock that Wynnefield Partners Small Cap Value, L.P. I directly beneficially owns.

(3) The Reporting Person has an indirect beneficial ownership interest in 542,418 shares of Common Stock, which are directly beneficially owned by Wynnefield Small Cap Value Offshore Fund, Ltd., as members of a group under Section 13(d) of the Exchange Act. Wynnefield Small Cap Value Offshore Fund, Ltd., which maintains offices at the same address as the Reporting Person, is filing this statement jointly with the Reporting Person. Wynnefield Capital, Inc. as the sole investment manager of Wynnefield Small Cap Value Offshore Fund, Ltd., has an indirect beneficial ownership interest in the shares of Common Stock that Wynnefield Small Cap Value Offshore Fund, Ltd. directly beneficially owns. Nelson Obus and Joshua Landes, as principal executive officers of Wynnefield Capital, Inc., have an indirect beneficial ownership interest in the shares of Common Stock that Wynnefield Small Cap Value Offshore Fund, Ltd. directly beneficially owns.

(4) The Reporting Person has an indirect beneficial ownership interest in 129,235 shares of Common Stock, which are directly beneficially owned by Wynnefield Capital, Inc. Profit Sharing Plan, as members of a group under Section 13(d) of the Exchange Act. Wynnefield Capital, Inc. Profit Sharing Plan, which maintains offices at the same address as the Reporting Person, is filing this statement jointly with the Reporting Person. Mr. Obus and Mr. Landes, as co-trustees, have the power to vote and dispose of Wynnefield Capital, Inc. Profit Sharing Plan's investments in securities and have indirect beneficial ownership interests in the shares of Common Stock that Wynnefield Capital, Inc. Profit Sharing Plan directly beneficially owns.

**Remarks:**
Each of the Reporting Owners identified in this statement disclaims beneficial ownership of the securities described in this statement, except to the extent of their individual respective pecuniary interest in such securities. The filing of this statement shall not be deemed an admission that any of the Reporting Owners identified in this statement are, for purposes of Section 16 of the Exchange Act or otherwise, the beneficial owner of any securities specified in this statement other than those directly beneficially owned by them.

**Signature:** /s/ Nelson Obus, Managing Member, By: Wynnefield Capital Management, LLC, General Partner, WYNNEFIELD PARTNERS SMALL CAP VALUE, L.P.  
**Date:** 2023-02-09

**Signature:** /s/ Nelson Obus, Managing Member, By: Wynnefield Capital Management, LLC, General Partner, WYNNEFIELD PARTNERS SMALL CAP VALUE, L.P. I  
**Date:** 2023-02-09

**Signature:** /s/ Nelson Obus, President, By: Wynnefield Capital, Inc., WYNNEFIELD SMALL CAP VALUE OFFSHORE FUND, LTD.  
**Date:** 2023-02-09

**Signature:** /s/ Nelson Obus, Managing Member, WYNNEFIELD CAPITAL MANAGEMENT, LLC  
**Date:** 2023-02-09

**Signature:** /s/ Nelson Obus, President, WYNNEFIELD CAPITAL, INC.  
**Date:** 2023-02-09

**Signature:** /s/ Nelson Obus, General Partner, WYNNEFIELD CAPITAL INC. PROFIT SHARING PLAN  
**Date:** 2023-02-09

**Signature:** /s/ Nelson Obus, individually  
**Date:** 2023-02-09

**Signature:** /s/ Joshua Landes, individually  
**Date:** 2023-02-09

### Remarks:

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.

* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).

** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.

**Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.**