Affidavit Of No Sales Form

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(Rev. 11/98)
AFFIDAVIT OF NO SALES
STATE OF NEW MEXICO
I, the undersigned, ___________________________________________, being first duly sworn,
upon oath state:
I am an official of the broker-dealer firm of ______________________________ (hereinafter
“Broker-dealer”) and, as such, authorized to make this affidavit on behalf of Broker-dealer.
Broker-dealer has not transacted business as a broker-dealer in New Mexico. Broker-dealer
agrees to comply with the New Mexico Securities Act of 1986 and to refrain from transacting business as
a broker-dealer in New Mexico until such time as both Broker-dealer and an agent thereof are duly
licensed by the New Mexico Securities Division.
I have executed this Affidavit in behalf of Broker-dealer after having read and understanding the
contents hereof, and with the knowledge that the representations contained herein will be verified with
Broker-dealer’s clearing broker(s).
I hereby represent that all information contained herein is true, current and complete, to the best
of my knowledge and belief.
Dated this _____ day of ________________________, _________.
_____________________________________________
(Print Broker-dealer Name)
By: __________________________________________
(Signature of Authorized Official)
Title: ________________________________________
ACKNOWLEDGMENT
STATE OF ____________________________ )
) ss.
COUNTY OF __________________________ )
On this _____ day of ____________________________, _________, before me personally
appeared _____________________________________, to me known to be the person described in and
who executed the foregoing instrument and acknowledged to me that he/she executed the same as
his/her free act and deed.
______________________________________
(Notarial seal)
Notary Public
My Commission expires:
_________________________

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