Free SEC894.P65 - Federal

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

OMB APPROVAL OMB Number: 3235-0044 Expires: April 30, 2009 Estimated average burden hours per response . . . . . . . . . . . . . . 3

FORM X-15AJ-1
File No. ____________________
1

Amendatory and/or Supplementary Statement to Registration Statement of
_________________________________________________________ (Name of Association) Amendatory and/or Supplementary Statement No.2 ________________ Date of registration statement _____________________________ The above registration statement is hereby amended and/or supplemented as indicated in the attached pages in respect of the items and/or exhibits listed below. _____________________________________________ (SEAL) (Association) By _____________________________________________ (Name) _____________________________________________ (Title)

Attest: _________________________________________ (Name) _________________________________________ (Title)

_________________________________________ (Date) ___________________________________ Instructions Attention is called to Rule O-3 which applies to this form. Every amendment and/or supplement shall be filed in triplicate, and shall be accompanied by one copy of a signed and attested statement on Form X-15AJ-1, to which one copy of each amendment and/or supplement must be attached. Any number of amendments and/or supplements may be listed on one such Form X-15AJ-1 and attached thereto, but each amendment and/or supplement must be set out on a page or pages on which no other amendment and/or supplement appears. If an amendment and/or supplement to one item or exhibit involves a change in or addition to other items or exhibits (as where an addition to the rules of an association requires a citation of the new rule in the answer to one or more questions) each item or exhibit affected must be amended and/or supplemented. Indicate at the top of each page on which an amendment and/or supplement is set out (1) the name of the association, (2) the number and date of the amendatory and/or supplementary statement of which the page is a part, and (3) the item or exhibit of the registration statement which is amended and/or supplemented by the particular page.
_________________ 1 If known, insert file number assigned by the Commission to the original registration statement, otherwise leave blank. 2 Amendatory and/or supplementary statements must be numbered by the association in order of filing.

SEC 894 (4-01)

Persons who are to 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.