Outside Business Activity Disclosure - Veritas Independent Partners printable pdf download

Outside Business Activity Disclosure - Veritas Independent Partners

Outside Business Activity Approval Form

Name of Representative: ______________________________________________________

Rep ID#____________________________________________________________________

Initial notification

Update Previously approved request

According to FINRA Rule 3030, Veritas Independent Partners must maintain an accurate and up to

date record of all outside business activities conducted by its registered representatives.

It is

important that you notify us if you are, or plan to be, involved in any outside business activity

including but not limited to, selling real estate, insurance sales, financial planning, estate planner, or

registered investment advisor.

Unpaid volunteer activity need not be disclosed, EXCEPT

membership on a board of an organization. Approval by way of a principal signed OBA form must

be obtained prior to engaging in the activity

NOTE: Selling insurance (any lines, including Universal Life, Whole and Term Life, Disability and

Fixed Annuities) is considered an outside business activity.

Please complete, sign and date this notification form and return it to Veritas Independent

Partners compliance department via email or fax.

A copy should be retained for your records and all changes must be promptly reported

to the Compliance Department.

1. Are you currently involved in any business other than securities business with Veritas

Independent Partners?

NO, I am not participating in any outside business activity. (

go to the signature line

sign and return

)

to Veritas

NO, but I am requesting permission to engage in an outside activity (

complete and sign this form)

YES

(complete and sign this form)

*Please fill out a separate questionnaire for each business activity

2. Name of Business____________________________________________________________________

Address____________________________________________________________________________

Phone #____________________________________________________________________________

3. Nature of Business___________________________________________________________________

4. Is this business a Corporation, Partnership, Sole Proprietorship, etc? (If yes, Circle correct structure)

Outside Business Activity Disclosure - Veritas Independent Partners