Note: Number of Items in Batch Total Shares in Batch (right justified, zero filled) Total Extended Contract Amount in Batch (right justified, zero filled, no punctuation) NNNNNNNNNNNN Blank - Not Used TOTAL SHARES and AMOUNT are not applicable for Advisory data. 2 2 XMOTCY THE ABOVE UNCOMPARED ITEM WAS SUBMITTED TO NCC HY "SELLER" INDICATING YOU AS PURCHASER. 1. IMPRINT YOUR NAME & NUMBER STAMP 2. RETURN COPIES 1 & 2 IN ACCORDANCE 3. KEEP COPY 3 AS YOUR RECORD OF ADD NCC 25 REV 10-71 1 INSTRUCTIONS TO NCC ADD THE ABOVE ITEM EXACTLY AS PRINTED TO OUR PURCHASE CONTRACT LIST. PURCHASER'S NAME & NUMBER STAMP THE ABOVE UNCOMPARED ITEM WAS SUBMITTED TO NC BY TURCHASER" INDICATING YOU SELLEK 1 INSTRUCTIONS, TO NCC ADD ABOVE 11 MEXACTLY AS PRINTE O TO OUR SALE CONTRACT LIST. SELLER'S NAME & NUME I STAMP EXHIBIT G Date NCC MEMBERSHIP SURVEY Please answer all questions and return by August 15, 1972. 4. 5. If you do not have a NASDAQ Market Maker Symbol, request one (must be four alpha characters) and NCC will confer with NASD/NASDAQ and confirm this assignment to you. Selection: Indicate the location(s) at which you wish to submit trade data (check as many as desired). This determines where your contract lists will be made available. New York Boston Indicate the location with which you wish to Settle your trades (Check only one): |