Instructions For Form Br - Uniform Branch Office Registration Form (Page 4 of 4) in pdf

INSTRUCTIONS

Rev. Form BR (10/2005)

UNIFORM BRANCH OFFICE FORM

be entered in the available comment field when at least one of

constitutes in every way, use, or aspect, his or her legally

the available arrangement sections are incomplete. Comments

binding signature.

will not be allowed when any of the arrangement sections are

Signature of Appropriate Signatory. Enter the name of the

complete. If multiple space sharing arrangements are intended

by the applicant, this section is to be answered for each

Appropriate Signatory. The name must be typed or printed (if

separate entity with information specific to each arrangement.

paper filing) as it appears in signature form. By typing a name

in this field, the signatory acknowledges that this entry

7. BRANCH CLOSING

constitutes in every way, use, or aspect, his or her legally

binding signature.

If you are closing a branch office registered with an SRO

Name/Title/Telephone Number of Person Filing the Form. Enter

or jurisdiction, complete the following information.

the name, title, and telephone number of the person filing the

Select the type of registration you are terminating: Broker-

form.

dealer and/or Investment Adviser.

Date operations ceased, or will cease, at the branch office

Date. Enter the month, day, and year that the application or

Enter the month, day, and year the branch closed or intends to

amendment is being signed. Future dates may not be entered

close.

in this section.

Location of Books and Records

Address Street 1/Street 2

Enter the address of the location (or locations, if more than

one) of the books and records for the branch office.

City

Enter the name of the city of the location (or locations, if more

than one) of the books and records for the branch office.

State

Enter the state of the location (or locations, if more than one) of

the books and records for the branch office.

Country

Enter the country of the location (or locations, if more than one)

of the books and records for the branch office.

Postal Code

Enter the postal code of the location (or locations, if more than

one) of the books and records for the branch office.

Contact Name and Telephone Number

Name

Enter the name of the individual that can be contacted

regarding information on the books and records for the branch

office.

Daytime Telephone Number

Enter the daytime telephone number of the individual that can

be contacted regarding information on the books and records

for the branch office.

8. BRANCH WITHDRAWAL

If you are withdrawing a pending application, complete the

following information:

Date of Withdrawal

Enter the month, day, and year of withdrawal.

Reason for Withdrawal

Enter the reason for withdrawal.

Contact Name and Telephone Number

Name

Enter the name of the natural person that can be contacted

regarding information on the withdrawal of this branch office.

Daytime Telephone Number

Enter the daytime telephone number of the individual that can

be contacted regarding information on the withdrawal of this

branch office.

9. SIGNATURE

Please Read Carefully

All signatures required on this Form BR filing must be made in

this section. A “signature” includes a manual signature or an

electronically transmitted equivalent. For purposes of an

electronic form filing, a signature is affected by typing a name

in the designated signature field. By typing a name in this field,

the signatory acknowledges and represents that the entry

Page 4 of 4

Instructions For Form Br - Uniform Branch Office Registration Form Page 4

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