Connecticut Supplement State-Registered Investment Advisers Application Form
Download a blank fillable Connecticut Supplement State-Registered Investment Advisers Application Form in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Connecticut Supplement State-Registered Investment Advisers Application Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3Connecticut Supplement
State-Registered Investment Advisers
Applicant Information
Applicant Name:
Exact Name of Applicant as Stated in Item 1 of Form ADV
IRS Number:
Applicant’s IRS Employer Identification Number
Pre-Existing Clients
The undersigned certifies, on behalf of the above Applicant, that the Applicant has not rendered
investment advisory services to any Connecticut resident, and, if the Applicant is based in Connecticut,
that the Applicant has not rendered investment advisory services from Connecticut to residents of any
other jurisdiction.
The undersigned certifies, on behalf of the above Applicant, that the Applicant (you may check more
than one box):
Has rendered investment advisory services to Connecticut residents
Is Connecticut-based and has rendered investment advisory services from Connecticut to
residents of one or more other jurisdictions
Attach a Separate Schedule Providing the Following:
•
Each client’s name and address
•
Specific dates the Applicant rendered investment advisory services to each client
•
For each client, the amount of investment advisory fees collected on a yearly basis from
inception to the present
•
How each client was introduced to the Applicant
•
Amount of any referral fees paid in connection with each account; the source of the referral
fees; and the recipient of the referral fees
•
The exclusion or exemption, if any, under the Connecticut Uniform Securities Act on which the
Applicant relied in providing investment advice to each client
•
A copy of the investment advisory contract, if any, with each client
Settlements With Other Regulatory Bodies
The undersigned certifies, on behalf of the above Applicant, that the Applicant has not entered into,
and is not now negotiating any consent order, agreement, stipulation, settlement or other contractual
obligation with any state administrator for purposes of settling or otherwise disposing of allegations by
the administrator of violation of, or lack of compliance with, any state securities law or order.
The undersigned certifies, on behalf of the above Applicant, that the Applicant (you may check more
than one box):
Has entered into a consent order, agreement, stipulation, settlement or other contractual obligation
with a state administrator for purposes of settling or otherwise disposing of allegations by the
administrator of violation of, or lack of compliance with, any state securities law or order.
Is now negotiating a consent order, agreement, stipulation, settlement or other contractual
obligation with a state administrator for purposes of settling or otherwise disposing of allegations
by the administrator of violation of, or lack of compliance with, any state securities law or order.
ADVERTISEMENT
0 votes
Related Articles
Related forms
Equiniti Dividend Re-investment Plan Application Form - Jpmorgan Smaller Companies Investment Trust
Business
Equiniti Dividend Re-investment Plan Application Form - Jpmorgan Emerging Markets Investment Trust
Business
Related Categories
Parent category: Legal