# EDGAR Filing Document

**Accession Number:** 0002009246
**File Stem:** 0000905148-25-002537
**Filing Date:** 2025-7
**Character Count:** 23539
**Document Hash:** 8f231a51915e23224195f9b3ea046d01
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0000905148-25-002537.hdr.sgml**: 20250723

**ACCESSION NUMBER**: 0000905148-25-002537

**CONFORMED SUBMISSION TYPE**: 3

**PUBLIC DOCUMENT COUNT**: 4

**CONFORMED PERIOD OF REPORT**: 20250723

**FILED AS OF DATE**: 20250723

**DATE AS OF CHANGE**: 20250723

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Schwartz Keoni Andrew
- **CENTRAL INDEX KEY:** 0002009246

**ORGANIZATION NAME:**

**FILING VALUES:**
- **FORM TYPE:** 3
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-42765
- **FILM NUMBER:** 251144347

**MAIL ADDRESS:**
- **STREET 1:** C/O ACCELERANT RE (CAYMAN) LTD.
- **STREET 2:** #106, WINDWARD 3, REGATTA OFFICE PARK
- **CITY:** WEST BAY ROAD, GRAND CAYMAN
- **STATE:** E9
- **ZIP:** KY1-1108
**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** ACP Insurance Management, LLC
- **CENTRAL INDEX KEY:** 0002078277

**ORGANIZATION NAME:**
- **STATE OF INCORPORATION:** E9
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** 3
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-42765
- **FILM NUMBER:** 251144345

**BUSINESS ADDRESS:**
- **STREET 1:** 400 HAMILTON AVE.
- **STREET 2:** SUITE 230
- **CITY:** PALO ALTO
- **STATE:** CA
- **ZIP:** 94301
- **BUSINESS PHONE:** 650-264-7750

**MAIL ADDRESS:**
- **STREET 1:** 400 HAMILTON AVE.
- **STREET 2:** SUITE 230
- **CITY:** PALO ALTO
- **STATE:** CA
- **ZIP:** 94301
**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** ACP Accelerant Holdings, L.P.
- **CENTRAL INDEX KEY:** 0002078270

**ORGANIZATION NAME:**
- **STATE OF INCORPORATION:** E9
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** 3
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-42765
- **FILM NUMBER:** 251144346

**BUSINESS ADDRESS:**
- **STREET 1:** 400 HAMILTON AVE.
- **STREET 2:** SUITE 230
- **CITY:** PALO ALTO
- **STATE:** CA
- **ZIP:** 94301
- **BUSINESS PHONE:** 650-264-7750

**MAIL ADDRESS:**
- **STREET 1:** 400 HAMILTON AVE.
- **STREET 2:** SUITE 230
- **CITY:** PALO ALTO
- **STATE:** CA
- **ZIP:** 94301
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** Accelerant Holdings
- **CENTRAL INDEX KEY:** 0001997350
- **STANDARD INDUSTRIAL CLASSIFICATION:** INSURANCE AGENTS BROKERS & SERVICES [6411]
- **ORGANIZATION NAME:** 02 Finance
- **EIN:** 981753044
- **STATE OF INCORPORATION:** E9
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** P.O. BOX 309 UGLAND HOUSE
- **CITY:** GRAND CAYMAN
- **STATE:** E9
- **ZIP:** KY1-1044
- **BUSINESS PHONE:** (302) 658-7581

**MAIL ADDRESS:**
- **STREET 1:** 1209 ORANGE STREET
- **STREET 2:** C/O THE CORPORATION TRUST COMPANY
- **CITY:** WILMINGTON
- **STATE:** DE
- **ZIP:** 19801

## Exhibit 24.1

------

#### POWER OF ATTORNEY
Know all by these present, that the undersigned hereby makes, constitutes and appoints each of Nancy Hasley and Robert Hardy, or either of them acting individually, and with full power of substitution, the undersigned's true and lawful attorney-in-fact to:

<sup>(1)</sup> prepare, execute in the undersigned's name and on the undersigned's behalf, and submit to the U.S. Securities and Exchange Commission (the "SEC") a Form ID, including amendments thereto, and any other documents necessary or appropriate to obtain codes and passwords enabling the undersigned to make electronic filings with the SEC of reports required by Section 13 or Section 16 of the Securities Exchange Act of 1934, Rule 144 under the Securities Act of 1933 ("Rule 144"), or any rule or regulation of the SEC;<br>

<sup>(2)</sup> execute for and on behalf of the undersigned, in the undersigned's capacity as an officer and/or director of Accelerant Holdings, a Cayman Islands exempted company (the "Company"), any and all reports under Section 13 or Section 16 of the Exchange Act or any rule or regulation thereunder, or under Rule 144, with respect to the any security of the Company, including Forms 3, 4 and 5, Schedules 13D and 13G, and Form 144;<br>

<sup>(3)</sup> do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4, or 5, Schedule 13D or 13G, or Form 144, complete and execute any amendment or amendments thereto, and timely file such form with the SEC and any stock exchange or similar authority; and<br>

<sup>(4)</sup> take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact's discretion.<br>

The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is the Company assuming, any of the undersigned's responsibilities to comply with Section 13(d) or Section 16 of the Securities Exchange Act of 1934 or Rule 144.

This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file reports with the SEC with respect to the undersigned's holdings of and transactions in securities issued by the Company, unless earlier (a) revoked by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact or (b) superseded by a new power of attorney regarding the purposes outlined herein at a later date.

IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 17th day of January, 2024.

---

| |
|:---|
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; /s/ Keoni Schwartz<br>|
| Signature |

---

<u> Keoni Andrew Schwartz<br> </u> <br> Print Name

------

## Exhibit 24.2

------

#### POWER OF ATTORNEY
Know all by these present, that the undersigned hereby makes, constitutes and appoints Jennifer Mello, with full power of substitution, the undersigned's true and lawful attorney-in-fact to:

<sup>(1)</sup> prepare, execute in the undersigned's name and on the undersigned's behalf, and submit to the U.S. Securities and Exchange Commission (the "SEC") a Form ID, including amendments thereto, and any other documents necessary or appropriate to obtain codes and passwords enabling the undersigned to make electronic filings with the SEC of reports required by Section 13 or Section 16 of the Securities Exchange Act of 1934, Rule 144 under the Securities Act of 1933 ("Rule 144"), or any rule or regulation of the SEC;<br>

<br> (2) serve as an Account Administrator for the undersigned's account in the SEC's enhanced Electronic Data Gathering, Analysis, and Retrieval system ("EDGAR Next");

<sup>(3)</sup> execute for and on behalf of the undersigned, in the undersigned's capacity as an officer, director, or 10% beneficial owner of Accelerant Holdings, a Cayman Islands exempted company (the "Company"), any and all reports under Section 13 or Section 16 of the Exchange Act or any rule or regulation thereunder, or under Rule 144, with respect to the any security of the Company, including Forms 3, 4 and 5, Schedules 13D and 13G, and Form 144;<br>

<sup>(4)</sup> do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4, or 5, Schedule 13D or 13G, or Form 144, complete and execute any amendment or amendments thereto, and timely file such form with the SEC and any stock exchange or similar authority; and<br>

<sup>(5)</sup> take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact's discretion.<br>

The undersigned hereby grants to such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorney-in-fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is the Company assuming, any of the undersigned's responsibilities to comply with Section 13(d) or Section 16 of the Securities Exchange Act of 1934 or Rule 144.

This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file reports with the SEC with respect to the undersigned's holdings of and transactions in securities issued by the Company, unless earlier (a) revoked by the undersigned in a signed writing delivered to the foregoing attorney-in-fact or (b) superseded by a new power of attorney regarding the purposes outlined herein at a later date.

IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 22nd day of July 2025.

<u> ACP Accelerant Holdings, L.P.<br> </u> <br>

<u> By: ACP Insurance Management, LLC, its general partner<br> </u>

---

| |
|:---|
| By:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; /s/ Samuel Gaynor |
| Print Name: Samuel Gaynor |
| Title:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Vice President |

---

------

## Exhibit 24.3

#### POWER OF ATTORNEY
Know all by these present, that the undersigned hereby makes, constitutes and appoints Jennifer Mello, with full power of substitution, the undersigned's true and lawful attorney-in-fact to:

<sup>(1)</sup> prepare, execute in the undersigned's name and on the undersigned's behalf, and submit to the U.S. Securities and Exchange Commission (the "SEC") a Form ID, including amendments thereto, and any other documents necessary or appropriate to obtain codes and passwords enabling the undersigned to make electronic filings with the SEC of reports required by Section 13 or Section 16 of the Securities Exchange Act of 1934, Rule 144 under the Securities Act of 1933 ("Rule 144"), or any rule or regulation of the SEC;<br>

<br> (2) serve as an Account Administrator for the undersigned's account in the SEC's enhanced Electronic Data Gathering, Analysis, and Retrieval system ("EDGAR Next");

<sup>(3)</sup> execute for and on behalf of the undersigned, in the undersigned's capacity as an officer, director, or 10% beneficial owner of Accelerant Holdings, a Cayman Islands exempted company (the "Company"), any and all reports under Section 13 or Section 16 of the Exchange Act or any rule or regulation thereunder, or under Rule 144, with respect to the any security of the Company, including Forms 3, 4 and 5, Schedules 13D and 13G, and Form 144;<br>

<sup>(4)</sup> do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4, or 5, Schedule 13D or 13G, or Form 144, complete and execute any amendment or amendments thereto, and timely file such form with the SEC and any stock exchange or similar authority; and<br>

<sup>(5)</sup> take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact's discretion.<br>

The undersigned hereby grants to such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorney-in-fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is the Company assuming, any of the undersigned's responsibilities to comply with Section 13(d) or Section 16 of the Securities Exchange Act of 1934 or Rule 144.

This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file reports with the SEC with respect to the undersigned's holdings of and transactions in securities issued by the Company, unless earlier (a) revoked by the undersigned in a signed writing delivered to the foregoing attorney-in-fact or (b) superseded by a new power of attorney regarding the purposes outlined herein at a later date.

IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 22nd day of July 2025.

<u> ACP Insurance Management, LLC<br> </u>

---

| |
|:---|
| By:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; /s/ Samuel Gaynor |
| Print Name: Samuel Gaynor |
| Title:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Vice President |

---

------

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

## FORM 3

### INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>Schwartz Keoni Andrew<br><sub>(Last) (First) (Middle)</sub><br>400 HAMILTON AVENUE<br>SUITE 230<br><sub>(Street)</sub><br>PALO ALTO, CA 94301<br><sub>(City) (State) (Zip)</sub> | **3. Issuer Name and Ticker or Trading Symbol**<br>Accelerant Holdings [ ARX ] | **5. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  |
| **2. Date of Event Requiring Statement (Month/Day/Year)**<br>2025-07-23 | **4. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[X] Director   [X] 10% Owner<br>[ ] Officer (give title below)   [ ] Other (specify below)<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>ACP Accelerant Holdings, L.P.<br><sub>(Last) (First) (Middle)</sub><br>400 HAMILTON AVENUE<br>SUITE 230<br><sub>(Street)</sub><br>PALO ALTO, CA 94301<br><sub>(City) (State) (Zip)</sub> | **3. Issuer Name and Ticker or Trading Symbol**<br>Accelerant Holdings [ ARX ] | **5. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  |
| **2. Date of Event Requiring Statement (Month/Day/Year)**<br>2025-07-23 | **4. 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>_ _ | **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>ACP Insurance Management, LLC<br><sub>(Last) (First) (Middle)</sub><br>400 HAMILTON AVENUE<br>SUITE 230<br><sub>(Street)</sub><br>PALO ALTO, CA 94301<br><sub>(City) (State) (Zip)</sub> | **3. Issuer Name and Ticker or Trading Symbol**<br>Accelerant Holdings [ ARX ] | **5. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  |
| **2. Date of Event Requiring Statement (Month/Day/Year)**<br>2025-07-23 | **4. 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>_ _ | **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 Beneficially Owned

---

|  |  |  |  |
| --- | --- | --- | --- |
| 1. Title of Security | 2. Amount of Securities Beneficially Owned | 3. Ownership Form | 4. Nature of Indirect Beneficial Ownership |

---

## Table II - Derivative Securities Beneficially Owned

---

|  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Underlying Securities | 3. Title and Amount of Underlying Securities | 4. Conversion or Exercise Price | 5. Ownership Form | 6. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 4. Conversion or Exercise Price | 5. Ownership Form | 6. Nature of Indirect Beneficial Ownership |
| LP Interests of Accelerant Holdings LP | <sup>(1)</sup> | <sup>(1)</sup> | Class B Common Shares | 90196595 | <sup>(1)</sup> | I | See Footnote<sup>(2)</sup> |
| LP Interests of Accelerant Holdings LP | <sup>(1)</sup> | <sup>(1)</sup> | Class B Common Shares | 2670456 | <sup>(1)</sup> | I | See Footnote<sup>(3)</sup> |
| Convertible Preference Shares | <sup>(4)</sup> | <sup>(4)</sup> | Class B Common Shares | 5427970 | <sup>(4)</sup> | I | See Footnote<sup>(5)</sup> |
| Convertible Preference Shares | <sup>(4)</sup> | <sup>(4)</sup> | Class B Common Shares | 3628575 | <sup>(4)</sup> | I | See Footnote<sup>(6)</sup> |
| Redeemable Preference Shares | <sup>(7)</sup> | <sup>(7)</sup> | Common Shares | 909791 | <sup>(7)</sup> | I | See Footnote<sup>(5)</sup> |

---

### Footnotes:

(1) In connection with the Issuer's initial public offering ("IPO"), these limited partnership interests of Accelerant Holdings LP will be exchanged for Class B Common Shares of the Issuer in proportion to the economic interests represented by the limited partnership interests.

(2) These securities are held directly by ACP Accelerant Holdings, L.P. Each of (i) ACP Insurance Management, LLC, as the general partner of ACP Accelerant Holdings, L.P., and (ii) Keoni Schwartz ("Mr. Schwartz"), as the sole owner and managing member of ACP Insurance Management, LLC, may be deemed to have voting and dispositive power over these securities, but disclaim beneficial ownership over these securities except to the extent of their respective pecuniary interest therein, if any.

(3) These securities are held directly by ACP Accelerant Investment Holding Company, Ltd. ACP Accelerant Holdings, L.P. is the sole owner of ACP Accelerant Investment Holding Company, Ltd. Each of (i) ACP Insurance Management, LLC, as the general partner of ACP Accelerant Holdings, L.P., and (ii) Mr. Schwartz, as the sole owner and managing member of ACP Insurance Management, LLC, may be deemed to have voting and dispositive power over these securities, but disclaim beneficial ownership over these securities except to the extent of their respective pecuniary interest therein, if any.

(4) In connection with the Issuer's IPO, these shares of the Issuer's Preference Shares will automatically be converted into Class B Common Shares of the Issuer at a 1-for-1 conversion rate.

(5) These securities are held directly by ACP Accelerant Co-Invest, LLC. Each of (i) ACP Insurance Management, LLC, as the managing member of ACP Accelerant Co-Invest, LLC, and (ii) Mr. Schwartz, as the sole owner and managing member of ACP Insurance Management, LLC, may be deemed to have voting and dispositive power over these securities, but disclaim beneficial ownership over these securities except to the extent of their respective pecuniary interest therein, if any.

(6) These securities are held directly by ACP Accelerant Investment Holding Company II, Ltd. ACP Accelerant Holdings, L.P. is the sole owner of ACP Accelerant Investment Holding Company II, Ltd. Each of (i) ACP Insurance Management, LLC, as the general partner of ACP Accelerant Holdings, L.P., and (ii) Mr. Schwartz, as the sole owner and managing member of ACP Insurance Management, LLC, may be deemed to have voting and dispositive power over these securities, but disclaim beneficial ownership over these securities except to the extent of their respective pecuniary interest therein, if any.

(7) In connection with the Issuer's IPO, holders of shares of the Issuer's Redeemable Preference Shares have the right to elect to convert the shares into Common Shares at a 1-for-1 conversion rate, or to have the shares redeemed at a redemption price of $31.55 per share. ACP Accelerant Co-Invest, LLC has elected to have its shares redeemed at a redemption price of $31.55 per share.

**Remarks:**
Exhibit List: Exhibit 24.1 - Power of Attorney; Exhibit 24.2 - Power of Attorney; Exhibit 24.3 - Power of Attorney

**Signature:** Keoni Andrew Schwartz, By: /s/  Robert Hardy, Attorney-in-Fact  
**Date:** 2025-07-23

**Signature:** ACP Accelerant Holdings, L.P., By: /s/ Jennifer Mello, Attorney-in-Fact  
**Date:** 2025-07-23

**Signature:** ACP Insurance Management, LLC, By: /s/ Jennifer Mello, Attorney-in-Fact  
**Date:** 2025-07-23

### 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.**