Form USR-1

USR-1

Form USR-1 Investment Company Report of Sales

File/Permit No. ________________

Investment Company Report of Sales

To the State of

_______________________________________________

For the 12 Month Period Beginning _______________________ Ending _______________________

Fund ____________________________________________

Address _________________________________________

Contact Person _________________________________

Phone Number _________________________________

Beginning Balance $ _____________

Additional Amounts Authorized During this Period (if any) $ _____________

Total Available for Sale $ _____________

Sales During this Period $ _____________

Ending Balance $ _____________

We certify that the foregoing is a complete report of sales for this Fund during the period specified.

Date:__________________________________ _________________________________
(Fund)

By:_________________________________
(Authorized Signature)

Beginning Balance	$	_____________
Additional Amounts Authorized During this Period (if any)	$	_____________
Total Available for Sale	$	_____________
Sales During this Period	$	_____________
Ending Balance	$	_____________

Date:__________________________________	_________________________________ (Fund)
	By:_________________________________ (Authorized Signature)