Free Form SH - Federal

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UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549

TEMPORARY FORM SH WEEKLY REPORT OF SHORT SALES AND SHORT POSITIONS Report for the Period Ended: _____[Month, Day, Year]_______ Check here if Amendment [ ]; Amendment Number: _____ This Amendment (Check only one): [ ] is a restatement. [ ] adds new entries. Institutional Investment Manager Filing this Report: Name: Address: ______________________________________ ______________________________________ ______________________________________ ______________________________________

Form 13F File Number: 28-_______________ Central Index Key (CIK) Number: _________________ The institutional investment manager filing this report and the person by whom it is signed hereby represent that the person signing the report is authorized to submit it, that all information contained herein is true, correct and complete, and that it is understood that all required items, statements, schedules, lists, and tables, are considered integral parts of this form.

Person Signing this Report on Behalf of Reporting Manager: Name: ___________________________ Title: ___________________________ Phone: ___________________________

Signature, Place, and Date of Signing

_______________________________ [Signature]

____________________ [City, State]

____________ [Date]

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Report Type (Check only one): [ ] FORM SH ENTRIES REPORT. (Check here if all entries of this reporting manager are reported in this report.) [ ] FORM SH NOTICE. (Check here if no entries reported are in this report, and all entries are reported by other reporting manager(s).) [ ] FORM SH COMBINATION REPORT. (Check here if a portion of the entries for this reporting manager is reported in this report and a portion is reported by other reporting manager(s).) List of Other Managers Reporting for this Manager: Provide a list of the name(s), Form 13F file number(s) and CIK numbers of all institutional investment managers who are reporting for this manager.

[If there are no entries in this list, state "NONE".] Number of Other Included Managers: _____________________
Total Number of Transactions Reported: _____________________

List of Other Included Managers: Provide a numbered list of the name(s) and Form 13F file number(s) and CIK numbers of all institutional investment managers with respect to which this Form SH report is filed, other than the manager filing this report. [If there are no entries in this list, state "NONE".]

INFORMATION TABLE

Element 1

Element 2

Element 3

Element 4

Element 5

Element 6

Element 7

Date

CIK of Manager

Name of Issuer

CUSIP

Short Position (Start of Day)

Number of Securities Sold Short (Day)

Short Position (End of Day)

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