259.212a—Form U-12(I)-A, for statement of activity within scope of section 12(i) of the Act pursuant to Rule 71(a) (§ 250.71(a) of this chapter).
This form shall be filed pursuant to Rule 71(a) ( § 250.71(a) of this chapter) by any person who engages in any activity within the scope of section 12(i) of the Act.