Form M-1 - Broker-Dealer Statement - 1989

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N.Y. Form M-1
** File No. _________
(Rev. 4/89)
(for renewals only)
STATE OF NEW YORK
Office of the Attorney General
BUREAU OF INVESTOR PROTECTION AND SECURITIES
BROKER-DEALER STATEMENT
(Section 359-e Gen. Bus. Law)
Firm
Principal
Name_________________________ Office_________________________________
Telephone No.__________________ Street Address
City
State
Zip Code
Branch Offices In New York State: Name and Address
____________________________________________________________________________________
____________________________________________________________________________________
If registrant is applying to sell its own issues (securities of which it is the issuer),
the registrant must file on NY Form M-11, Issuer Statement.
1. Is registrant now licensed, or otherwise qualified to transact securities or
commodities business in any other State
......................................................... Yes [ ] No [ ]
If answer is "YES" list States _______________________________________________
2. Has registrant, any officer, director or principal or partner ever
A. been suspended or expelled from membership in any securities or commodities
exchange, association of securities commodities dealers or investment or
commodities trading advisors or counsel
.................................................... Yes [ ] No [ ]
B. had a license or registration as a dealer, broker, investment advisor,
salesperson futures commission merchant, associated person commodity
pool operator, or commodity trading advisor denied, suspended or
revoked?
.................................................... Yes [ ] No [ ]
C. been enjoined or restrained by any court or government agency from:
1. the issuance, sale or offer for sale or 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

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