120 Broadway, 35th floor
New York, NY 10271
(212) 618-0570
(212) 968-0746

Membership Application

THE CORPORATE ACTIONS DIVISION, INC. SIFMA

MEMBERSHIP APPLICATION

The Corporate Actions Division Inc.
c/o James Boyle
Goldman Sachs Group,Inc.
email: james.boyle@gs.com
Fax number 917 977 3064

Firm Name:

Address:

City/State/Zip:

Clearing Number:

Please indicate which member will be the Firm Coordinator (Name):

Member Name:

Member Title:

Department:

Work Telephone:
Fax Number:

EMail Address:

Member Name:

Member Title:

Department:

Work Telephone:
Fax Number:

EMail Address:

Member Name:

Member Title:

Department:

Work Telephone:
Fax Number:

EMail Address:

Membership Dues Are $60 Per Member.

Total Number of Members: _______

If paying by credit card, please complete this section and mail or fax to address or number below:

1) Pay by Credit Card: $__________ Total Payment

____ VISA
____ MasterCard ____ American Express

Credit Card Number:

Expiration Date:

Name on Credit Card:

Billing Address:


I hereby authorize payment of the amount specified above (Total Payment) to be charged to my credit card.

Cardholder's Signature (required):

Date:

2) Amount of Enclosed Check: $_______ Total Payment

Make check payable to CORPORATE ACTIONS DIVISION.

Mail application and check (if applicable) to the following address:

The Corporate Actions Division Inc,
c/o James Boyle Goldman Sachs

30 Hudson St 4th Floor

Jersey City NJ 07302

If you are interested in membership or if you need information, send your inquiries to sifma-divisions@sifma.org.

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