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FOCUS REPORT FORM X17A5 (Financial and Operational Combined Uniform Single Report) Part II 11 (Read instructions before preparing Form) This report is being filed pursuant to (Check Applicable Block(s)):
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4 special request by is a form used to request special accommodations or exceptions.
Any individual or organization that requires special accommodations or exceptions.
You can fill out 4 special request by by providing detailed information about the requested special accommodations or exceptions.
The purpose of 4 special request by is to ensure that individuals or organizations receive the necessary accommodations or exceptions.
You must report detailed information about the special accommodations or exceptions being requested.
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