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Your Name _______________________________ CRD Number _______________

FORM ADV

Part 1A

Date _____________________________________ SEC 801-Number ____________

Page 10 of 16

Item 7

Financial Industry Affiliations

In this Item, we request information about your financial industry affiliations and activities. This information

identifies areas in which conflicts of interest may occur between you and your clients.

Item 7 requires you to provide information about you and your related persons. Your related persons are all of

your advisory affiliates and any person that is under common control with you.

A. You have a related person that is a (check all that apply):

⁪

(1) broker-dealer, municipal securities dealer, or government securities broker or dealer

⁪

(2) investment company (including mutual funds)

⁪

(3) other investment adviser (including financial planners)

⁪

(4) futures commission merchant, commodity pool operator, or commodity trading advisor

⁪

(5) banking or thrift institution

⁪

(6) accountant or accounting firm

⁪

(7) lawyer or law firm

⁪

(8) insurance company or agency

⁪

(9) pension consultant

⁪

(10) real estate broker or dealer

⁪

(11) sponsor or syndicator of limited partnerships

If you checked Item 7.A(3), you must list on Section 7.A. of Schedule D all your related persons that are

investment advisers. If you checked Item 7.A.(1), you may elect to list on Section 7.A. of Schedule D all

your related persons that are broker-dealers. If you choose to list a related broker-dealer, the IARD will

accept a single Form U-4 to register an investment adviser representative who also is a broker-dealer

agent (“registered rep”) of that related broker-dealer.

B. Are you or any related person a general partner in an investment-related limited partnership or manager of

an investment-related limited liability company, or do you advise any other “private fund,” as defined

⁪

under SEC rule 203(b)(3)-1?

Yes

If "yes," for each limited partnership or limited liability company, or (if applicable) private fund, complete

Section 7.B. of Schedule D. If, however, you are an SEC-registered adviser and you have related persons

that are SEC-registered advisers who are the general partners of limited partnerships or the managers of

limited liability companies, you do not have to complete Section 7.B. of Schedule D with respect to those

related advisers’ limited partnerships or limited liability companies.

To use this alternative procedure, you must state in the Miscellaneous Section of Schedule D: (1) that you

have related SEC-registered investment advisers that manage limited partnerships or limited liability

companies that are not listed in Section 7.B. of your Schedule D; (2) that complete and accurate

information about those limited partnerships or limited liability companies is available in Section 7.B. of

Schedule D of the Form ADVs of your related SEC-registered advisers; and (3) whether your clients are

solicited to invest in any of those limited partnerships or limited liability companies.

Item 8

Participation or Interest in Client Transactions

In this Item, we request information about your participation and interest in your clients’ transactions. Like Item 7,

this information identifies areas in which conflicts of interest may occur between you and your clients.

Like Item 7, Item 8 requires you to provide information about you and your related persons.

Form Sec 1707 - Uniform Application For Investment Adviser Registration - Securities And Exchange Commission Page 10

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