U.S. Securities & Exchange Commission
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U.S. Securities and Exchange Commission

Enforcement Complaint Form

Please provide the information in the space allotted or add additional information at the bottom and press "submit this form" - or send to SEC Division of Enforcement, 100 F Street, N.E. Washington, D.C. 20549. We may share the information you provide with others. Read the Privacy Act Notice to learn more about how we may use the information you send to us.

Information About You

Your Name:
Email Address:
Your Address:
Phone Number:

Information About Your Complaint

Type of Security:
Entity Name:
Names, Address, Telephone #s and Other Biographical Information
about Individuals Involved
How you Learned about the Transaction or other Activity
Who Contacted you:
Sales Material in Your Possession
Details About the Transaction(S)
If on the Internet, All Relevant Internet Addresses

Any Additional Information

Use this area to add any additional information that you wish.


Modified: 10/11/2005