Form Sec 1707 - Uniform Application For Investment Adviser Registration - Securities And Exchange Commission Page 32

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CIVIL JUDICIAL ACTION DISCLOSURE REPORTING PAGE (ADV)
GENERAL INSTRUCTIONS
This Disclosure Reporting Page (DRP ADV) is an
INITIAL OR
AMENDED response used to report details for
affirmative responses to Item 11.H. of Part 1A and Item 2.F. of Part 1B of Form ADV.
Check Part 1A item(s) being responded to:
11.H(1)(a)
11.H(1)(b)
11.H(1)(c)
11.H(2)
Check Part 1B item(s) being responded to:
2.F(1)
2.F(2)
2.F(3)
2.F(4)
2.F(5)
Use a separate DRP for each event or proceeding. The same event or proceeding may be reported for more than one person or
entity using one DRP. File with a completed Execution Page.
One event may result in more than one affirmative answer to Item 11.H. of Part 1A or Item 2.F. of Part 1B. Use only one DRP
to report details related to the same event. Unrelated civil judicial actions must be reported on separate DRPs.
PART I
A. The person(s) or entity(ies) for whom this DRP is being filed is (are):
You (the advisory firm)
You and one or more of your advisory affiliates
One or more of your advisory affiliates
If this DRP is being filed for an advisory affiliate, give the full name of the advisory affiliate below (for individuals, Last
name, First name, Middle name).
If the advisory affiliate has a CRD number, provide that number. If not, indicate "non-registered" by checking the
appropriate box.
Your Name
Your CRD Number
ADV DRP - ADVISORY AFFILIATE
CRD Number
This advisory affiliate is
a firm
an individual
Registered:
Yes
No
Name (For individuals, Last, First, Middle)
This DRP should be removed from the ADV record because the advisory affiliate(s) is no longer associated with the
adviser.
This DRP should be removed from the ADV record because: (1) the event or proceeding occurred more than ten
years ago or (2) the adviser is registered or applying for registration with the SEC and the event was resolved in the
adviser’s or advisory affiliate’s favor.
If you are registered or registering with a state securities authority, you may remove a DRP for an event you reported only
in response to Item 11.H(1)(a), and only if that event occurred more than ten years ago. If you are registered or registering
with the SEC, you may remove a DRP for any event listed in Item 11 that occurred more than ten years ago.
B.
If the advisory affiliate is registered through the IARD system or CRD system, has the advisory affiliate submitted a DRP
(with Form ADV, BD or U-4) to the IARD or CRD for the event? If the answer is “Yes,” no other information on this DRP
must be provided.
Yes
No
NOTE:
The completion of this form does not relieve the advisory affiliate of its obligation to update its IARD or CRD
records.
(continued)
SEC 1707 (01-08)
File 2 of 4

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