Form Bd Uniform Application For Broker-Dealer Registration Page 24
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28CIVIL JUDICIAL ACTION DISCLOSURE REPORTING PAGE (BD)
(continuation)
If Final or On Appeal, complete all items below. For Pending Actions, complete Item 14 only.
11. How was matter resolved: (check appropriate item)
Consent
Judgment Rendered
Settled
Dismissed
Opinion
Withdrawn
Other ___________________________
12. Resolution Date (MM/DD/YYYY):
Exact
Explanation
If not exact, provide explanation: ____________________________________________________________________________
13. Resolution Detail:
A. Were any of the following Sanctions Ordered or Relief Granted? (Check appropriate items):
Monetary/Fine
Revocation/Expulsion/Denial
Disgorgement/Restitution
Amount $
Censure
Cease and Desist/injunction
Bar
Suspension
B. Other Sanctions:
____________________________________________________________________________________________________________________
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C . Sanction detail: if suspended, enjoined or barred, provide duration including start date and capacities affected (General Securities
Principal, Financial Operations Principal, etc.). If requalification by exam/retraining was a condition of the sanction, provide length of time
given to requalify/retrain, type of exam required and whether condition has been satisfied. If disposition resulted in a fine, penalty,
restitution, disgorgement or monetary compensation, provide total amount, portion levied against applicant or control affiliate, date paid
and if any portion of penalty was waived:
____________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________
14. Provide a brief summary of circumstances related to action(s), allegation(s), disposition(s) and/or finding(s) disclosed above. (The
information must fit within the space provided.):
________________________________________________________________________________________________________________________
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