Form Bd Uniform Application For Broker-Dealer Registration (Page 9 of 28) in pdf

FORM BD

OFFICIAL

OFFICIAL USE

USE

Applicant Name:______________________________________________________________________

ONLY

PAGE 5

Date:____________________

Firm CRD No.: _______________

12. Check types of business engaged in (or to be engaged in, if not yet active) by applicant. Do not check any

category that accounts for (or is expected to account for) less than 1% of annual revenue from the securities

or investment advisory business.

A. Exchange member engaged in exchange commission business other than floor activities ......................................

EMC

EMF

B. Exchange member engaged in floor activities ..............................................................................................................

IDM

C. Broker or dealer making inter-dealer markets in corporate securities over-the-counter .............................................

BDR

D. Broker or dealer retailing corporate equity securities over-the-counter .......................................................................

BDD

E. Broker or dealer selling corporate debt securities ........................................................................................................

USG

F. Underwriter or selling group participant (corporate securities other than mutual funds) ...........................................

MFU

G. Mutual fund underwriter or sponsor ...............................................................................................................................

H. Mutual fund retailer .........................................................................................................................................................

MFR

GSD

U.S. government securities dealer ..........................................................................................................................

GSB

U.S. government securities broker .........................................................................................................................

MSD

Municipal securities dealer .............................................................................................................................................

MSB

K. Municipal securities broker. ............................................................................................................................................

VLA

L . Broker or dealer selling variable life insurance or annuities .........................................................................................

SSL

M. Solicitor of time deposits in a financial institution ..........................................................................................................

RES

N. Real estate syndicator. . ..................................................................................................................................................

OGI

O. Broker or dealer selling oil and gas interests ................................................................................................................

PCB

P. Put and call broker or dealer or option writer ................................................................................................................

BIA

Q. Broker or dealer selling securities of only one issuer or associate issuers (other than mutual funds) ......................

NPB

R. Broker or dealer selling securities of non-profit organizations (e.g., churches, hospitals) .........................................

IAD

S. Investment advisory services ..........................................................................................................................................

TAP

T. 1.

Broker or dealer selling tax shelters or limited partnerships in primary distributions ..........................................

TAS

Broker or dealer selling tax shelters or limited partnerships in the secondary market ........................................

NEX

U. Non-exchange member arranging for transactions in listed securities by exchange member ...................................

TRA

V. Trading securities for own account ................................................................................................................................

PLA

W. Private placements of securities .....................................................................................................................................

MRI

X. Broker or dealer selling interests in mortgages or other receivables ...........................................................................

Y. Broker or dealer involved in a networking, kiosk or similar arrangement with a:

bank, savings bank or association, or credit union ...............................................................................................

BNA

insurance company or agency ................................................................................................................................

INA

OTH

Z. Other (give details on Schedule D, Page 1, Section II) ..................................................................................................

YES NO

13. A. Does applicant effect transactions in commodity futures, commodities or commodity options as a broker for

others or as a dealer for its own account? .............................................................................................................

B. Does applicant engage in any other non-securities business? .............................................................................

If “yes,” describe each other business briefly on Schedule D, Page 1, Section ll.