Uniform Application For Securities Industry Registration Or Transfer Page 6
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8Rulemaking Board?
(8) found you to have failed reasonably to supervise another person subject to your supervision, with a view to preventing the violation of
any provision of the Securities Act of 1933, the Securities Exchange Act of 1934, the Investment Advisers Act of 1940, the Investment
Company Act of 1940, the Commodity Exchange Act, or any rule or regulation under any of such Acts, or any of the rules of the
Municipal Securities Rulemaking Board?
14D. (1) Has any other Federal regulatory agency or any state regulatory agency or foreign financial regulatory authority ever:
(a) found you to have made a false statement or omission or been dishonest, unfair or unethical?
(b) found you to have been involved in a violation of investmentrelated regulation(s) or statute(s)?
(c) found you to have been a cause of an investmentrelated business having its authorization to do business denied, suspended, revoked or
restricted?
(d) entered an order against you in connection with an investmentrelated activity?
(e) denied, suspended, or revoked your registration or license or otherwise, by order, prevented you from associating with an investment
related business or restricted your activities?
(2) Have you been subject to any final order of a state securities commission (or any agency or officer performing like
functions), state authority that supervises or examines banks, savings associations, or credit unions, state insurance
commission (or any agency or office performing like functions), an appropriate federal banking agency, or the National
Credit Union Administration, that:
(a) bars you from association with an entity regulated by such commission, authority, agency, or officer, or from engaging in the business of
securities, insurance, banking, savings association activities, or credit union activities; or
(b) constitutes a final order based on violations of any laws or regulations that prohibit fraudulent, manipulative, or deceptive conduct?
14E. Has any selfregulatory organization ever:
(1) found you to have made a false statement or omission?
(2) found you to have been involved in a violation of its rules (other than a violation designated as a "minor rule violation" under a plan
approved by the U.S. Securities and Exchange Commission)?
(3) found you to have been the cause of an investmentrelated business having its authorization to do business denied, suspended, revoked
or restricted?
(4) disciplined you by expelling or suspending you from membership, barring or suspending your association with its members, or restricting
your activities?
(5) found you to have willfully violated any provision of the Securities Act of 1933, the Securities Exchange Act of 1934, the Investment
Advisers Act of 1940, the Investment Company Act of 1940, the Commodity Exchange Act, or any rule or regulation under any of such
Acts, or any of the rules of the Municipal Securities Rulemaking Board, or found you to have been unable to comply with any provision of
such Act, rule or regulation?
(6) found you to have willfully aided, abetted, counseled, commanded, induced, or procured the violation by any person of any provision of
the Securities Act of 1933, the Securities Exchange Act of 1934, the Investment Advisers Act of 1940, the Investment Company Act of
1940, the Commodity Exchange Act, or any rule or regulation under any of such Acts, or any of the rules of the Municipal Securities
Rulemaking Board?
(7) found you to have failed reasonably to supervise another person subject to your supervision, with a view to preventing the violation of
any provision of the Securities Act of 1933, the Securities Exchange Act of 1934, the Investment Advisers Act of 1940, the Investment
Company Act of 1940, the Commodity Exchange Act, or any rule or regulation under any of such Acts, or any of the rules of the
Municipal Securities Rulemaking Board?
14F.
Have you ever had an authorization to act as an attorney, accountant or federal contractor that was revoked or suspended?
14G.
Have you been notified, in writing, that you are now the subject of any:
(1) regulatory complaint or proceeding that could result in a "yes" answer to any part of 14C, D or E? (If yes, complete the Regulatory
Action Disclosure Reporting Page.)
(2) investigation that could result in a "yes" answer to any part of 14A, B, C, D or E? (If yes, complete the Investigation Disclosure
Reporting Page.)
Civil Judicial Disclosure
14H. (1) Has any domestic or foreign court ever:
YES NO
(a) enjoined you in connection with any investmentrelated activity?
(b) found that you were involved in a violation of any investmentrelated statute(s) or regulation(s)?
(c) dismissed, pursuant to a settlement agreement, an investmentrelated civil action brought against you by a state or foreign financial
regulatory authority?
(2) Are you named in any pending investmentrelated civil action that could result in a "yes" answer to any part of 14H(1)?
Customer Complaint/Arbitration/Civil Litigation Disclosure
14I. (1) Have you ever been named as a respondent/defendant in an investmentrelated, consumerinitiated arbitration or civil
YES NO
litigation which alleged that you were involved in one or more sales practice violations and which:
(a) is still pending, or;
(b) resulted in an arbitration award or civil judgment against you, regardless of amount, or;
(c) was settled, prior to 05/18/2009, for an amount of $10,000 or more, or;
(d) was settled, on or after 05/18/2009, for an amount of $15,000 or more?
(2) Have you ever been the subject of an investmentrelated, consumerinitiated (written or oral) complaint, which alleged that
you were involved in one or more sales practice violations, and which:
(a) was settled, prior to 05/18/2009 for an amount of $10,000 or more, or;
(b) was settled, on or after 05/18/2009, for an amount of $15,000 or more?
(3) Within the past twenty four (24) months, have you been the subject of an investmentrelated, consumerinitiated, written
complaint, not otherwise reported under question 14I(2) above, which:
(a) alleged that you were involved in one or more sales practice violations and contained a claim for compensatory damages of $5,000 or
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