Outside Business Activity And Dba Form (Page 5 of 5) in pdf

Outside Business Activity Disclosure Form Review

__________________________________________ __________________________________________________

Registered Representative Name (print)

OBA Name (print)

Chief Compliance Officer review of OBA

I have reviewed this OBA Disclosure and I choose to:

 Object ❑ Not Object

to the Registered Representative’s involvement in this activity.

I have determined that the activity will not interfere with or otherwise compromise the RR’s responsibilities to

the Firm and/or the Firm’s customers for the following reasons:

_________________________________________________________________________________________

I have determined that customers or members of the public will not view the activity as part of the Firm’s

business for the following reasons:

_________________________________________________________________________________________

❑

I have determined that specific conditions or limitations on the activity

will or

will

not be imposed.*

I have determined that the activity is properly characterized as an outside business activity rather than an outside

securities activity for the following reasons:

If I have chosen to Not Object to the outside business activity disclosed, then I understand that the FAF Written

Supervisory Procedures Manual also provides that not all disclosed activities need to be filed with FINRA as current

employment activities.

Upon review of this OBA disclosure I have determined that this particular activity:

Is an activity that constitutes a current employment activity and must be disclosed to FINRA on Form U-4.

Is an activity that does not constitute a current employment activity and does not need to be disclosed to

FINRA.

This disclosure will be retained by the Registration Department for FAF record keeping purposes only.

CCO Signature: ________________________________________________ Date: ________________

*(A letter from the CCO will follow this form if the OBA is objected to and this statement will need to be

signed by the Registered Representative at that time.)

Registered Representative Acknowledgment of Objection to OBA:

By affixing my signature below, I certify that I am not involved, nor will I become involved, with the OBA

identified above while registered with the Firm. If I have had any previous involvement in this activity while

registered with the Firm, I certify that I will immediately cease all such involvement and have outlined below all

pertinent details surrounding my previous affiliation with this entity.

Description of previous involvement with the OBA:

__________________________________________________________________________________________

Registered Representative Signature:

_______________________________________________________________ Date: ________________

M:FAFSERVER DOCSFIRST ASSET FINANCIALFAF FormsRep Outsde Activity FormsOutside Business Activity Form 8-13.doc

Outside Business Activity And Dba Form Page 5