Table I - Non-Derivative Securities Beneficially Owned

<table><tr><td>1. Title of Security (Instr. 4)</td><td>2. Amount of Securities Beneficially Owned (Instr. 4)</td><td>3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)</td><td>4. Nature of Indirect Beneficial Ownership (Instr. 5)</td></tr><tr><td>Common Stock</td><td>0</td><td>D</td><td></td></tr></table>

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)

<table><tr><td rowspan="2">1. Title of Derivative Security (Instr. 4)</td><td colspan="2">2. Date Exercisable and Expiration Date (Month/Day/Year)</td><td colspan="2">3. Title and Amount of Securities Underlying Derivative Security (Instr. 4)</td><td rowspan="2">4. Conversion or Exercise Price of Derivative Security</td><td rowspan="2">5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)</td><td rowspan="2">6. Nature of Indirect Beneficial Ownership (Instr. 5)</td></tr><tr><td>Date Exercisable</td><td>Expiration Date</td><td>Title</td><td>Amount or Number of Shares</td></tr></table>