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Securities and Exchange Commission OMB Number: 3235-0410

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FORM 17-H
RISK ASSESSMENT REPORT FOR BROKERS AND DEALERS

PART I
Risk Assessment Reporting Requirements for Brokers and Dealers

NAME OF REPORTING BROKER-DEALER SEC FILE NO. ____________________12

____________________________________________ 14 CRD NO. __________________________ 16
ADDRESS OF PRINCIPAL PLACE OF BUSINESS
____________________________________________________________________________________ 18
FIRM I.D. NO.
____________________________________________ 20 FILING TYPE: (Check Appropriate Boxes)
FOR PERIOD BEGINNING (MM/DD/YY) QUARTERLY ANNUAL AMENDED
______________________________________________ 22
26 28 30
AND ENDING (MM/DD/YY)
______________________________________________ 24
NAME AND TELEPHONE NUMBER OF PERSON TO CONTACT IN REGARD TO THIS REPORT
______________________________________________ 32
NAME(S) OF MATERIAL ASSOCIATED PERSONS CONTAINED IN THIS REPORT:
______________________________________________ 34 ____________________________________ 36
______________________________________________ 38 ____________________________________ 40
______________________________________________ 42
NAME OF ASSOCIATED BROKER-DEALER(S) NOT FILING (If applicable)
________________________________________________
44 ____________________________________ 46
______________________________________________ 48 ____________________________________ 50
______________________________________________ 52

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

Intentional misstatements or omissions of facts may also result in civil fines and other sanctions pursuant to Section
20 of the Securities Exchange Act of 1934.

The person signing this report represents hereby that all information contained in this Form is true, correct and
complete. It is understood that all information in this Form is considered an integral part of this Form and that the
submission of any amendment represents that all unamended information remains true, correct and complete as
previously filed.

Pursuant to the Securities Exchange Act of 1934, the undersigned has caused this report to be signed on its behalf in
the City of __________________ and State of _______________ on the ___ day of ____________, 20___.

__________________________________________
(Name of Broker-Dealer)

________________________________________________________________________________________
(Signature and Title of Person Duly Authorized to Submit This Report)

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 control number. SEC 2332 (2-07)
 GENERAL INSTRUCTIONS

1. This Form consists of two parts. Part I consists of the organizational, policy and legal information required
by paragraphs (a)(1)(i) through (iii) of section 240.17h-1T, together with the financial statements required by
paragraphs (a)(1)(iv) and (v) of section 240.17h-1T. Part II contains line items for reporting the numerical and
other data required by paragraphs (a)(1)(vi) through (x) of section 240.17h-1T.

2. Report as of the last day of the fiscal quarter. This Form is to be filed within 60 calendar days of the end of
each fiscal quarter by brokers and dealers concerning each Material Associated Person (as defined in Temporary
Rules 17h-1T and 17h-2T). The Form for the fourth fiscal quarter shall be filed within 60 calendar days of the
end of the fiscal year. The cumulative year-end financial statements required by paragraphs (a)(1)(iv) and (v)
of section 240.17h-1T may be filed separately within 105 calendar days of the end of the fiscal year.

3. In the event a broker or dealer is associated with one or more other registered brokers or dealers, each broker
or dealer is required to file a separate Form 17-H. The Commission may exempt from the filing requirements
all brokers or dealers associated with a broker or dealer that has been designated a “Reporting Broker or Dealer.”
The term “Reporting Broker or Dealer” shall have the meaning set forth in Rules 17h-1T and 17h-2T. A broker
or dealer seeking designation as a Reporting Broker or Dealer must apply to the Commission for an exemption
pursuant to Rule 17h-2T. Pending such designation, each broker or dealer associated with the broker or dealer
requesting such designation as a Reporting Broker or Dealer is required to file a separate Form 17-H.

4. The information requested in Part II of this Form shall be completed separately for each Material Associated
Person, even if the financial data contained in the broker or dealer’s Form X-17A-5 contains information
concerning a Material Associated Person. The broker-dealer should not include information concerning its
activities in the information required by Part II of this Form if such information is filed with the Commission as
part of the broker-dealer’s Form X-17A-5 or Form G-405.

ITEM 1
ORGANIZATIONAL CHART REFLECTING ASSOCIATED PERSONS AND THE BROKER-DEALER
1. Provide a copy of the organizational chart maintained by the broker or dealer pursuant to paragraph (a)(1)(i)
of section 240.17h-1T.
2. The information provided pursuant to this Item should be included in the first Form 17-H filed by the broker
or dealer and in the year-end filing. Quarterly updates should be provided only where a material change in the
information provided to the Commission has occurred.

ITEM 2
RISK MANAGEMENT AND OTHER POLICIES
1. Provide copies of the financing, capital adequacy, and risk management and other policies, procedures or
systems maintained by the broker-dealer pursuant to paragraph (a)(1)(ii) of section 240.17h-1T.
2. The information provided pursuant to this Item should be included in the first Form 17-H filed by the broker
or dealer. Quarterly updates should be provided only where a material change in the information provided to the
Commission has occurred.

ITEM 3
LEGAL PROCEEDINGS
1. Provide the description of any material pending legal or arbitration proceedings maintained by the broker or
dealer pursuant to paragraph (a)(1)(iii) of section 240.17h-1T.
2. The information provided pursuant to this Item should be included in the first Form 17-H filed with the
Commission. Quarterly updates should be provided only where a material change in the information provided
to the Commission has occurred.

ITEM 4
FINANCIAL STATEMENTS
1. Provide the information required to be maintained by the broker or dealer pursuant to paragraphs (a)(1)(iv)
and (a)(1)(v) of section 240.17h-1T. The financial statements may be presented on an unaudited basis. The
statement of cash flows and the notes to financial statements may be omitted for the consolidating financial
statements. Entities using accounting principles other than U.S. GAAP should indicate in a note the accounting
principles used.
2. The consolidating financial statements must be presented on a subsidiary basis and shall indicate which
subsidiaries are Material Associated Persons.

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 PART II
GENERAL INSTRUCTIONS FOR PART II OF THIS FORM

1. Provide the following information for each Material Associated Person as of the end of the quarter. Indicate the name of each
Material Associated Person in a separate column or complete a separate Part II for each Material Associated Person. In the event a
separate listing of a position, financial instrument or otherwise is required pursuant to any of the provisions of section 240.17h-1T, the
broker or dealer should indicate as such in the appropriate section of this Part II. Where appropriate, indicate long and short positions
separately. (Report amounts in thousands) Material Associated Person:____________________________________

I. AGGREGATE SECURITIES AND COMMODITIES POSITIONS LONG (000's omitted) SHORT

1. U.S. Treasury securities .......................................................... 1000 1005
2. U.S. Government agency ........................................................ 1010 1015
3. Securities issued by states and political subdivisions in the U.S. 1020 1025
4. Foreign securities:
(a) Debt securities .................................................................. 1030 1035
(b) Equity securities ............................................................... 1040 1045
5. Banker’s acceptances ............................................................. 1050 1055
6. Certificates of deposit ............................................................. 1060 1065
7. Commercial paper ................................................................... 1070 1075
8. Corporate obligations ............................................................. 1080 1085
9. Stocks and warrants (other than arbitrage positions) .............. 1090 1095
10. Arbitrage:
(a) Index arbitrage and program trading ................................ 1100 1105
(b) Risk arbitrage ................................................................... 1110 1115
(c) Other arbitrage ................................................................. 1120 1125
11. Options:
(a) Market value of put options:
(i) Listed ......................................................................... 1130 1135
(ii) Unlisted ...................................................................... 1140 1145
(b) Market value of call options:
(i) Listed ........................................................................... 1150 1155
(ii) Unlisted ...................................................................... 1160 1165
12. Spot commodities ................................................................... 1170 1175
13. Investments with no ready market:
(a) Equity .............................................................................. 1180 1185
(b) Debt ................................................................................. 1190 1195
(c) Other (include limited partnership interests) .................... 1200 1205
14. Other securities or commodities ............................................. 1210 1215
15. Summary of delta or similar analysis (if available)(attach analysis)

II. FINANCIAL INSTRUMENTS WITH OFF-BALANCE SHEET RISK AND WITH CONCENTRATION OF CREDIT RISK
(Provide notional or contractual amounts where appropriate, or in the case of options, the values of the underlying instrument. In the
event a separate listing of a position or instrument is required pursuant to the provisions of section 17h-1T, separately state such position.)

A. Securities
1. When-issued securities: LONG (000's omitted) SHORT
(a) Gross commitments to purchase ....................................... 2000 2005
(b) Gross commitments to sell ................................................ 2010 2015
2. Written stock option contracts:
(a) Market value, and the value of the underlying securities,
of call contracts:
(i) Listed
(A) Market value ....................................................... 2020 2025
(B) Value of underlying securities ............................ 2030 2035
(ii) Unlisted
(A) Market value ...................................................... 2040 2045

(B) Value of underlying securities ............................ 2050 2055

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 Material Associated Person:______________________________
LONG (000's omitted) SHORT

(b) Market value, and the value of the underlying securities,

of put contracts:
(i) Listed
(A) Market value ....................................................... 2060 2065
(B) Value of underlying securities ............................ 2070 2075
(ii) Unlisted
(A) Market value ....................................................... 2080 2085
(B) Value of underlying securities ............................ 2090 2095
(c) Market value, and the value of the underlying securities,
of naked call contracts:
(i) Listed
(A) Market value ....................................................... 2100 2105
(B) Value of underlying securities ............................ 2110 2115
(ii) Unlisted
(A) Market value ....................................................... 2120 2125
(B) Value of underlying securities ............................ 2130 2135
(d) Market value, and the value of the underlying securities,
of naked put contracts:
(i) Listed
(A) Market value ....................................................... 2140 2145
(B) Value of underlying securities ............................ 2150 2155
(ii) Unlisted
(A) Market value ....................................................... 2160 2165
(B) Value of underlying securities ............................ 2170 2175
3. Futures:
(a) U.S. Treasury and mortgage-backed securities futures...... 2180 2185
(b) Other futures (specify) ...................................................... 2190 2195
4. Forwards:
(a) U.S. Treasury and mortgage-backed securities ................. 2200 2205
(i) Aggregate current cost of replacing contracts by counter-
party in which the Material Associated Person has a gain 2210 2215
(ii) Per counterparty breakdown where credit risk exceeds
the Materiality Threshold (attach schedule).
(b) Other forwards (specify) ................................................... 2220 2225
(i) Aggregate current cost of replacing contracts by counter-
party in which the Material Associated Person has a gain 2230 2235
(ii) Per counterparty breakdown where credit risk exceeds
the Materiality Threshold (attach schedule).
B. Interest Rate Swaps
1. U.S. dollar denominated swaps:
(a) Total notional or contractual amount ................................ 2240 2245
(b) Aggregate current cost of replacing contracts by counter-
party in which the Material Associated Person has a gain 2250 2255
(c) Per counterparty breakdown where credit risk exceeds
the Materiality Threshold (attach schedule).
2. Cross currency swaps:
(a) Total notional or contractual amount................................. 2260 2265
(b) Aggregate current cost of replacing contracts by counter-
party in which the Material Associated Person has a gain 2270 2275
(c) Per counterparty breakdown where credit risk exceeds
the Materiality Threshold (attach schedule).
C. Foreign exchange
1. Swaps:
(a) Total notional or contractual amount ................................ 2280 2285
(b) Aggregate cost of replacing contracts by counterparty in
which the Material Associated Person has a gain............... 2290 2295
(c) Per counterparty breakdown where credit risk exceeds
the Materiality Threshold (attach schedule).

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 Material Associated Person:_____________________________
LONG (000's omitted) SHORT

2. Notional or contractual amounts of commitments to purchase

foreign currencies and U.S. dollar exchange:
(a) Futures .............................................................................. 2300 2305
(b) Forwards ........................................................................... 2310 2315
(i) Aggregate current cost of replacing contracts by counter-
party in which the Material Associated Person has a gain. 2320 2325
(ii) Per counterparty breakdown where credit risk exceeds
the Materiality Threshold (attach schedule).
3. Naked written option contracts:
(a) Contractual value .............................................................. 2330 2335
(b) Value of the underlying instruments ................................. 2340 2345
D. All other swap agreements (specify type)(attach schedule if necessary)
1. Total notional or contractual amount ....................................... 2350 2355
2. Aggregate current cost of replacing contracts by counterparty in
which the Material Associated Person has a gain......................... 2360 2365
3. Per counterparty breakdown where credit risk exceeds the
Materiality Threshold (attach schedule).
E. Commodities
1. Futures ..................................................................................... 2370 2375
2. Forwards .................................................................................. 2380 2385
(a) Aggregate current cost of replacing contracts by counter-
party in which the Material Associated Person has a gain...... 2390 2395
(b) Per counterparty breakdown where credit risk exceeds the
Materiality Threshold (attach schedule).
3. Sold option contracts (e.g., options on individual commodities
and commodities indexes)
(a) Market value, and the value of the underlying instruments,
of call contracts:
(i) Listed
(A) Market value ....................................................... 2400 2405
(B) Value of underlying instruments.......................... 2410 2415
(ii) Unlisted
(A) Market value ....................................................... 2420 2425
(B) Value of underlying instruments ......................... 2430 2435
(b) Market value, and the value of the underlying instruments,
of put contracts:
(i) Listed
(A) Market value ....................................................... 2440 2445
(B) Value of underlying instruments ......................... 2450 2455
(ii) Unlisted
(A) Market value ....................................................... 2460 2465
(B) Value of underlying instruments ......................... 2470 2475
(c) Market value, and the value of the underlying instruments,
of naked call contracts:
(i) Listed
(A) Market value ....................................................... 2480 2485
(B) Value of underlying instruments ......................... 2490 2495
(ii) Unlisted
(A) Market value ....................................................... 2500 2505
(B) Value of underlying instruments ......................... 2510 2515
(d) Market value, and the value of the underlying instruments,
of naked put contracts:
(i) Listed
(A) Market value ....................................................... 2530 2525
(B) Value of underlying instruments ......................... 2520 2535
(ii) Unlisted
(A) Market value ....................................................... 2540 2545
(B) Value of underlying instruments ......................... 2550 2555
F. Loan committments
1. Total amount ............................................................................................................................. 2560
2. Unused portion .......................................................................................................................... 2565

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 Material Associated Person:______________________________
(000's omitted)
G. Total standby, commercial and similar letters of credit or guarantees ............................................ 2570
H. Assets sold with recourse ............................................................................................................... 2575
I. Other off-balance sheet items (specify) .......................................................................................... 2580
J. Summary of delta or similar analysis (if available)(attach analysis).
K. Provide a separate listing, by amount, of significant concentrations of credit risk as defined in
Statement of Financial Accounting Standards No. 105 (attach schedule).
(000's omitted)

III. BRIDGE LOANS AND OTHER EXTENSIONS OF CREDIT

1. Bridge loans .................................................................................................................................... 3000
2. Other material credit extensions (specify) ...................................................................................... 3005
3. Allowance for losses for credit extensions ..................................................................................... 3015

(000's omitted)
IV. FUNDING SOURCES
1. Short-term borrowings:
(a) Commercial paper .................................................................................................................... 4000
(b) Bank loans-secured .................................................................................................................. 4005
(c) Bank loans-unsecured .............................................................................................................. 4015
(d) Other ........................................................................................................................................ 4020
(e) Total ......................................................................................................................................... 4025
2. Long and medium-term debt .......................................................................................................... 4030
3. Committed lines of credit ................................................................................................................ 4035
4. Amounts borrowed under credit lines ............................................................................................. 4040
5. Credit ratings for commercial paper
(a) Standard & Poor’s Corporation ................................................................................................ 4045
(b) Moody’s Investor Service ........................................................................................................ 4050
(c) Other Nationally Recognized Statistical Rating Organizations ................................................ 4055

(000's omitted)
V. REAL ESTATE
1. Real estate loans:
(a) Construction and land development ......................................................................................... 5000
(b) Secured by farmland ................................................................................................................ 5005
(c) Secured by residential properties ............................................................................................. 5015
(d) Commercial and industrial ....................................................................................................... 5020
(e) Other ........................................................................................................................................ 5025
2. Real estate investments:
(a) Construction and land development ......................................................................................... 5030
(b) Farmland ................................................................................................................................... 5035
(c) Residential properties ............................................................................................................... 5040
(d) Commercial and industrial ....................................................................................................... 5045
(e) Other ......................................................................................................................................... 5050
3. Provide a separate listing of the above information by geographic region where the amount exceeds the Materiality Threshold (attach
schedule).
4. Provide information about risk concentration to a single borrower, location or property in the investment or loan portfolio where the
amount exceeds the Materiality Threshold (attach schedule).

ADDITIONAL SPACE FOR ANSWERS

The Material Associated Person may use the space below, and additional sheets if necessary, to provide further information or
explanation regarding any item of information required by the Form. Include the name of the Material Associated Person on each
page and specify the paragraph of the Form to which the additional information relates.

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