Form X 17A 19 PDF Details

Form X 17A 19 is a new form that the IRS has released to help with estate and gift tax returns. This new form will help simplify the process of filing for these taxes, and will make it easier for taxpayers to understand what is required of them. The IRS has also released instructions for how to complete this new form, which can be found on their website. If you are planning on making a large gift or estate transfer in the near future, be sure to review both the form and the instructions carefully to ensure that you submit everything correctly. Failing to do so could result in penalties and fines from the IRS.

QuestionAnswer
Form NameForm X 17A 19
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesformx 17a 19 sec form x 17a 5

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UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

OMB APPROVAL

OMB Number: 3235-0133

Expires: November 30, 2014 Estimated average burden hours per response. . . . . 0.25

FORM X-17A-19

INFORMATION REQUIRED OF NATIONAL SECURITIES EXCHANGES AND

REGISTERED NATIONAL SECURITIES ASSOCIATIONS PURSUANT TO SECTIONS 17

AND 19 OF THE SECURITIES EXCHANGE ACT OF 1934 AND RULE 17a-19 THEREUNDER

REPORT OF CHANGE IN MEMBERSHIP STATUS

1.Identify the self­regulatory organization filing this report.

AMEX

BSE

CBOE CSE

CHX

ISE

NASD

NYSE

2.The change in membership with the reporting self­regulatory organization is:

(a)

New Membership

(b)

Termination of Membership

(c)

(d)

Reinstatement from Suspension

(e)

Change of Address

(f)

PCX PHLX

Suspension of Membership

Other Change in Membership Status

If (b), (c), (d) or (f) give a brief description of the circumstances ___________________________________________________

_______________________________________________________________________________________________________

3.Provide the following information concerning the subject.

Present Status: (a) thru (d)

 

To be changed to (a) thru (d)

 

(a) Name _____________________________________

(a) Name ________________________________________

(b)

Corporation

Partnership

Sole Proprietor

(b)

Corporation

Partnership

Sole Proprietor

 

LLC

­ Other ___________________

 

LLC

­ Other ___________________

(c) SEC File No. _______________________________

(c) SEC File No. _______________________________

(d) Principal Place of Business:

 

(d) Principal Place of Business:

 

_____________________________________________

_____________________________________________

 

 

(Number and Street)

 

 

 

(Number and Street)

 

_____________________________________________

_____________________________________________

(City)

 

 

(State) (Zip Code)

(City)

 

 

(State) (Zip Code)

4.The subject is also a member of the:

AMEX BSE CBOE CSE CHX ISE NASD NYSE PCX PHLX

5.The examining authority and SIPC collection agent prior to this change in membership status is:

AMEX BSE CBOE CSE CHX ISE NASD NYSE PCX

PHLX

6.Name of person completing report _______________________________ Title __________________________________

Effective Date

Telephone No ______________________ Signature _________________________________ of Change ____________

(ADVISE BROKER-DEALER OF ITS OBLIGATION TO AMEND ITS FORM BD OR FILE FORM BDW)

RESERVED FOR SEC ACTION

Examining Authority Not Changed

Examining Authority Changed From _______________ to _______________

Signature __________________________________________________________ Date __________________________

INSTRUCTIONS ON BACK

SEC 1414 (07-01)

P e rsons who

conta ine d in

 

 

form d isp la ys

are to re sp ond to the colle ction of informa tion this form a re not re q uire d to re sp ond unle ss the

a curre ntly va lid O M B control numb e r .

GENERAL INSTRUCTIONS

FORM X-17A-19

1.This Form shall be completed and filed within 5 business days of the occurrence of one or more of the changes in membership status listed in Item 2 and/or 3 on this Form or promptly upon learning that such changes will occur. If the information first becomes available after the change in membership status has occurred, the Form shall be completed and filed promptly.

2. Original ­ Mail to:

U.S. Securities and Exchange Commission

 

Division of Market Regulation

 

100 F Street, N.E.

 

Washington, D.C. 20549­6628

Copy No. 1 ­ Mail to:

Securities Investor Protection Corporation

 

805 15th Street, N.W., Suite 800

 

Washington, D.C. 20005

Copy No. 2:

Retain for your files.

3.The original filed with the Securities and Exchange Commission and the copy filed with the Securities Investor Protection Corporation shall be executed with a manual signature by a duly authorized official of the national securities exchange or registered securities association (self­regulatory organization).

4.If the space provided in the Form for an answer to any Item is insufficient, the answer may be printed or typed on a separate insert page or pages which shall be incorporated into the statement by reference thereto in the space provided for the Item.

5.If any Item of the Form is inapplicable, a statement to that effect shall be made following the Item.

6.Change of member’s address is required to be reported only by the examining authority.

7.Copies of this Form may be obtained from the main office of the Securities and Exchange Commission in Washington, D.C.

8.The Securities and Exchange Commission will use a copy of this Form to notify Securities Investor Protection Corporation and the affected self­regulatory organizations of any action that is taken.

(ADVISE BROKER-DEALER OF ITS OBLIGATION TO AMEND ITS FORM BD OR FILE FORM BDW)

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This PDF form will require specific details; to ensure correctness, please pay attention to the recommendations directly below:

1. The Form X 17A 19 will require specific details to be typed in. Make certain the next blank fields are filled out:

Step number 1 of filling out Form X 17A 19

2. Your next part would be to submit the next few fields: Number and Street, Number and Street, City Zip Code, State, City Zip Code, State, The subject is also a member of, AMEX, BSE, CBOE, CSE, CHX, ISE, NASD, and NYSE.

Filling out section 2 of Form X 17A 19

When it comes to NYSE and ISE, make sure you don't make any errors in this current part. The two of these are the most significant fields in this form.

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