Blanket Issuer Letter of Representations Form
This file contains the Blanket Issuer Letter of Representations form required for securities eligibility at The Depository Trust Company. Users will find detailed instructions on how to fill out the form correctly to ensure compliance with DTC regulations. This document is vital for issuers and co-issuers seeking to deposit securities with DTC.
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How do I fill this out?
Filling out this form requires careful attention to detail. Start by entering the name of the issuer and co-issuer where indicated. Be sure to provide accurate contact information and ensure all signatures are properly executed.

How to fill out the Blanket Issuer Letter of Representations Form?
1
Identify and enter the name of the issuer and co-issuer.
2
Fill in the date of submission.
3
Complete all required fields with accurate information.
4
Ensure that an authorized officer signs the document.
5
Submit the completed form to the designated DTC department.
Who needs the Blanket Issuer Letter of Representations Form?
1
Securities issuers who want to deposit their securities with DTC.
2
Co-issuers who need to sign and represent consent for the issuance.
3
Investment banks that facilitate the securities issuance process.
4
Legal firms that assist in the preparation of issuer documentation.
5
Regulatory compliance teams ensuring adherence to DTC rules.
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What are the instructions for submitting this form?
To submit this form, email it to the DTC Underwriting Department at underwriting@dtcc.com. Alternatively, you can fax it to (123) 456-7890 or send it through the postal service to The Depository Trust Company, 18301 Bermuda Green Drive, Tampa, FL 33647. It is advisable to keep a copy for your records and follow up to confirm receipt.
What are the important dates for this form in 2024 and 2025?
Important dates for the use of this form include quarterly filing deadlines and annual compliance reviews, which should be noted in 2024 and 2025 for all issuers.

What is the purpose of this form?
The Blanket Issuer Letter of Representations serves as a formal request to The Depository Trust Company for eligibility of securities for deposit. This form ensures that issuers comply with DTC regulations and facilitate the smooth processing of transactions. It also documents the issuer's commitment to adhere to established operational protocols.

Tell me about this form and its components and fields line-by-line.

- 1. Issuer Name: The official name of the entity requesting deposit.
- 2. Co-Issuer Name: The name of any co-issuer, if applicable.
- 3. Date: The date the form is completed.
- 4. Authorized Officer's Signature: Signature of the individual authorized to submit the form.
- 5. Contact Information: Fields for address, phone number, and email.
What happens if I fail to submit this form?
If this form is not submitted correctly, the issuer may face delays in the eligibility process for securities. It could also result in compliance issues with DTC regulations.
- Delay in Process: Submitting incorrect information may postpone the eligibility date for the securities.
- Compliance Risks: Failure to meet DTC standards can lead to regulatory scrutiny.
- Financial Implications: Inability to deposit securities could affect funding and trading opportunities.
How do I know when to use this form?

- 1. Initial Securities Deposits: For issuers making their first deposit of newly issued securities.
- 2. Co-Issuer Participation: When co-issuers are involved in a securities offering.
- 3. Updates to Issuer Information: To update contact or issuer information as required by DTC.
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What information do I need to fill out?
Ensure you have the issuer's name, co-issuer's details, and accurate contact information ready to fill out the form.
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