Ny Form Cm-3 - Supplemental Commodity Statement Page 3

ADVERTISEMENT

1. the issuance, sale or offer for sale of
securities or commodities?............................. Yes [ ] No [ ]
2. rendering securities or commodities
advice or counsel?........................................ Yes [ ] No [ ]
3. handling or managing trading accounts?........... Yes [ ] No [ ]
4. continuing any practices in connection
with securities or commodities?...................... Yes [ ] No [ ]
D. Is any action or proceeding seeking the relief
enumerated in A - C presently pending?...................Yes [ ] No [ ]
E. been convicted of any crime?.......................... Yes [ ] No [ ]
F. used or been known by any other name?................. Yes [ ] No [ ]
G. been the subject of any professional
disciplinary proceeding?.............................. Yes [ ] No [ ]
H. been adjudged a bankrupt or made a general assignment
for benefit of creditors; been the subject of a
receivership or bankruptcy proceeding; been an officer,
director, principal, partner, manager, supervisor or any
10% or more equity holder of any entity which was
reorganized in bankruptcy, adjudged a bankrupt or made a
general assignment for benefit of creditors?............ Yes [ ] No [ ]
I. ever had a judgment entered against them or it which is
presently unsatisfied? (Not including judgments involving
domestic relations.)............................................ Yes [ ] No [ ]
J. been a party in any litigation or administrative proceeding
in which it is alleged that they or it committed fraud or
otherwise violated any provision of the Martin Act or any
other securities or commodities laws?.........................Yes [ ] No [ ]
K. if any answer to any of the above is "YES", attach statement
of full particulars.
A $10.00 fee must accompany this statement. Personal checks not accepted.
Attorney's check, bank check, certified check, money order only payable to
the N.Y.S. Office of the Attorney General. Attach additional sheets where space provided
is inadequate. You may submit a photocopy of this form. It will be returned
with your fee receipt for your records.
Send remittance to: Bureau of Investor Protection and Securities, 23rd Floor,
N.Y. Office of the Attorney General, 120 Broadway, New York, NY 10271.
DATED: _______________ Signature: ____________________________________________
STATE OF )
: S.:
COUNTY OF )
________________________________, being duly sworn, deposes and
says that I am the ___________________ (Title) of Registrant and I
signed the above form. I have read the questions and answers and
information supplied, and they are true, accurate and complete.

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Legal
Go
Page of 4