TA-1/A : Filer Information

Form Version X0405

Submission Contact Information

The registrant may provide a single e-mail address for contact purposes.

1(f)(i). Contact Name:
1(f)(ii). Contact Phone Number:
1(f)(iii). Contact E-Mail Address:

Notification Information

The registrant may provide additional e-mail addresses for those persons the filer would like to receive notification e-mails regarding the filing.

1(g). Notification E-mail Address:

TA-1/A : Registrant Information

3(c). Address of principal office where transfer agent activities are, or will be, performed:

7. Has registrant been engaged, or will it be engaged as a service company by a named transfer agent to perform transfer agent functions? radio button checked  Yes  radio button unchecked  No

If "Yes" provide the name(s) and File Number(s) of the named transfer agent(s) for which the registrant has been engaged, or will be engaged, as a service company to perform transfer agent functions:

Engaged transfer agent company information Related to item 7 Record: 1
7(a). Name
DST Systems, Inc.
7(b). File Number
7(c)(i). Address 1
210 W 10th Street
7(c)(ii). Address 2
7(c)(iii). City
Kansas City
7(c)(iv). State or Country
MISSOURI
7(c)(v). Postal Code
64105

Engaged transfer agent company information Related to item 7 Record: 2
7(a). Name
DST Asset Manager Solutions, Inc./TA
7(b). File Number
7(c)(i). Address 1
2000 Crown Colony Drive
7(c)(ii). Address 2
7(c)(iii). City
Quincy
7(c)(iv). State or Country
MASSACHUSETTS
7(c)(v). Postal Code
02169

TA-1/A : Independent, Non-Issuer Registrant Information

Completion of Question 8 on this form is required by all independent, non-issuer registrants whose appropriate regulatory authority is the Securities and Exchange Commission. Those registrants who are not required to complete Question 8 should select "Not Applicable".

Section for Initial Registration and for Amendments Reporting Additional Persons.

corporation or partner information Related to item 8 Record: 1
8(a)(i). Full Name
Pacific Ventures
8(a)(ii). Relationship Start Date
05/02/2005
8(a)(iii). Title or Status
24.58% Owner
8(a)(iv). Ownership Code
B
8(a)(v). Control Person checkbox unchecked  Yes 
8(a)(vi). Relationship End Date

corporation or partner information Related to item 8 Record: 2
8(a)(i). Full Name
DST HealthCare Holdings, Inc.
8(a)(ii). Relationship Start Date
04/30/2005
8(a)(iii). Title or Status
75.42% Owner
8(a)(iv). Ownership Code
E
8(a)(v). Control Person checkbox unchecked  Yes 
8(a)(vi). Relationship End Date

corporation or partner information Related to item 8 Record: 3
8(a)(i). Full Name
DST Systems, Inc.
8(a)(ii). Relationship Start Date
04/30/2005
8(a)(iii). Title or Status
Indirect Ownership
8(a)(iv). Ownership Code
NA
8(a)(v). Control Person checkbox unchecked  Yes 
8(a)(vi). Relationship End Date

corporation or partner information Related to item 8 Record: 4
8(a)(i). Full Name
Manjula Cherukuri
8(a)(ii). Relationship Start Date
03/21/2005
8(a)(iii). Title or Status
Head of Finance, Director
8(a)(iv). Ownership Code
NA
8(a)(v). Control Person checkbox checked  Yes 
8(a)(vi). Relationship End Date

corporation or partner information Related to item 8 Record: 5
8(a)(i). Full Name
Raju Srinivasa Penmatcha
8(a)(ii). Relationship Start Date
12/31/2009
8(a)(iii). Title or Status
Head of BPO Services, Director
8(a)(iv). Ownership Code
NA
8(a)(v). Control Person checkbox checked  Yes 
8(a)(vi). Relationship End Date
10/31/2019

corporation or partner information Related to item 8 Record: 6
8(a)(i). Full Name
Kevin Lysaught
8(a)(ii). Relationship Start Date
03/25/2019
8(a)(iii). Title or Status
Director
8(a)(iv). Ownership Code
NA
8(a)(v). Control Person checkbox checked  Yes 
8(a)(vi). Relationship End Date

corporation or partner information Related to item 8 Record: 7
8(a)(i). Full Name
David Fellows
8(a)(ii). Relationship Start Date
03/25/2019
8(a)(iii). Title or Status
Director
8(a)(iv). Ownership Code
NA
8(a)(v). Control Person checkbox checked  Yes 
8(a)(vi). Relationship End Date

corporation or partner information Related to item 8 Record: 8
8(a)(i). Full Name
Chris Benner
8(a)(ii). Relationship Start Date
06/28/2019
8(a)(iii). Title or Status
Director
8(a)(iv). Ownership Code
NA
8(a)(v). Control Person checkbox checked  Yes 
8(a)(vi). Relationship End Date

9. Does any person or entity not named in the answer to Question 8:

9(a). directly or indirectly, through agreement or otherwise exercise or have the power to exercise control over the management or policies of applicant, or;…. radio button unchecked  Yes  radio button checked  No
9(b). wholly or partially finance the business of the applicant, directly or indirectly, in any manner other than by a public offering of securities made pursuant to the Securities Act of 1933 or by credit extended in the ordinary course of business by suppliers, banks and others?….. radio button unchecked  Yes  radio button checked  No

TA-1/A : 10. Applicant and Control Affiliate Disciplinary History

The following definitions apply for purposes of answering this Question 10

Control Affiliate- An individual or firm that directly or indirectly controls, is under common control with, or is controlled by applicant. Included are any employees identified in 8(a), 8(b), 8(c) of this form as exercising control. Excluded are any employees who perform solely clerical, administrative support of similar functions, or who, regardless of title, perform no executive duties or have no senior policy making authority.
Investment or investment related- Pertaining to securities, commodities, banking, insurance, or real estate (including, but not limited to, acting as or being associated with a broker dealer, investment company, investment adviser, futures sponsor, bank, or savings and loan association).
Involved- Doing an act of aiding, abetting, counseling, commanding, inducing, conspiring with or failing reasonably to supervise another in doing an act.

10(a). In the past ten years has the applicant or a control affiliate been convicted of or plead guilty or nolo contendere ("no contest") to:

10(a)(1). a felony or misdemeanor involving: investments or an investment-related business, fraud, false statements or omissions, wrongful taking of property, or bribery, forgery, counterfeiting, or extortion? radio button unchecked  Yes  radio button checked  No
10(a)(2). any other felony? radio button unchecked  Yes  radio button checked  No
10(b). Has any court in the past ten years:
10(b)(1). enjoined the applicant or a control affiliate in connection with any investment-related activity? radio button unchecked  Yes  radio button checked  No
10(b)(2). found that the applicant or control affiliate was involved in a violation of investment-related statutes or regulations? radio button unchecked  Yes  radio button checked  No
10 (c). Has the U.S. Securities and Exchange Commission or the Commodity Futures Trading Commission ever:
10(c)(1). found the applicant or control affiliate to have made a false statement or omission? radio button unchecked  Yes  radio button checked  No
10(c)(2). found the applicant or control affiliate to have been involved in a violation of its regulation or statutes? radio button unchecked  Yes  radio button checked  No
10(c)(3). found the applicant or control affiliate to have been a cause of an investment-related business having its authorization to do business denied, suspended, revoked or restricted? radio button unchecked  Yes  radio button checked  No
10(c)(4). entered an order denying, suspending or revoking the applicant’s or control affiliate’s registration or otherwise disciplined it by restricting its activities? radio button unchecked  Yes  radio button checked  No
10(d). Has any other Federal regulatory agency or any state regulatory agency :
10(d)(1). ever found the applicant or control affiliate to have made a false statement or omission or to have been dishonest, unfair, or unethical? radio button unchecked  Yes  radio button checked  No
10(d)(2). ever found the applicant or control affiliate to have been involved in a violation of investment-related regulations or statutes? radio button unchecked  Yes  radio button checked  No
10(d)(3). ever found the applicant or control affiliate to have been a cause of an investment-related business having its authorization to do business Denied, suspended, revoked or restricted? radio button unchecked  Yes  radio button checked  No
10(d)(4). in the past ten years entered an order against the applicant or control affiliate in connection with investment-related activity? radio button unchecked  Yes  radio button checked  No
10(d)(5). ever denied, suspended, or revoked applicant’s or control affiliate’s registration or license, or prevented it from associating with an investment-related business, or otherwise disciplined it by restricting its activities? radio button unchecked  Yes  radio button checked  No
10(d)(6). ever revoked or suspended the applicant’s or a control affiliate’s license as an attorney or accountant? radio button unchecked  Yes  radio button checked  No

10(e). Has any self-regulatory organization or commodities exchange ever:
10(e)(1). found the applicant or a control affiliate to have made a false statement or omission? radio button unchecked  Yes  radio button checked  No
10(e)(2). found the applicant or a control affiliate to have been involved in a violation of its rules? radio button unchecked  Yes  radio button checked  No
10(e)(3). found the applicant or a control affiliate to have been the cause of an investment-related business losing its authorization to do business? radio button unchecked  Yes  radio button checked  No
10(e)(4). disciplined the applicant or a control affiliate by expelling or suspending it from membership, by barring or suspending its association with other members, or by otherwise restricting its activities? radio button unchecked  Yes  radio button checked  No
10(f). Has any foreign government, court, regulatory agency or exchange ever entered an order against the applicant or a control affiliate related to investments or fraud? radio button unchecked  Yes  radio button checked  No
10(g). Is the applicant or a control affiliate now the subject of a proceeding that could result in a yes answer for questions 10(a) – 10(f) ? radio button unchecked  Yes  radio button checked  No
10(h). Has a bonding company denied, paid out on, or revoked a bond for the applicant or a control affiliate? radio button unchecked  Yes  radio button checked  No
10(i). Does the applicant or a control affiliate have any unsatisfied judgments or liens against it? radio button unchecked  Yes  radio button checked  No

TA-1/A : Signature

ATTENTION: INTENTIONAL MISSTATEMENTS OR OMISSIONS OF FACT CONSTITUTE FEDERAL CRIMINAL VIOLATIONS. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a)

SIGNATURE: The registrant submitting this form, and as required, the SEC supplement and Schedules A-D, And the executing official hereby represent that all the information contained herein is true, correct and complete.