Form R-2 - Application For Registration, Renewal Or Amendment To An Application Of An Agent Page 4
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1
2
3
4CONSENT TO SERVICE OF PROCESS
The Applicant irrevocably appoints the Commissioner of Financial Institutions of Puerto Rico, and his successors in
Office, its attorney upon whom may be served any notice, process or pleading in any non-criminal action or
proceeding against it arising out of or in connection with the purchase or sale of securities, the conduct of the
securities business or the business of an investment adviser, or violation of the Uniform Securities Act of Puerto
Rico; and the undersigned does hereby consent that any such action proceeding against it may be commenced in any
court of competent jurisdiction and proper venue by service of process upon said officer with the same effect as if
the undersigned has been personally served with process in said jurisdiction.
It is requested that a copy of any notice, process or pleading served hereunder be mailed to the address given in Item
3 and 4.
EXECUTION
I, the undersigned Applicant, being duly sworn on oath, state that I have read and knowingly made the foregoing
statements and representations and that each and all such statements and representations are true, and ask that the
license herein applied for be granted. If the foregoing is an amendment to a current registration the undersigned
represents that the statements made in the amendment and in the current registration to the extent not corrected by
the amendment, are true, correct, and complete.
___________________________
__________________________________
Date of signing
Signature of Applicant
Affidavit Number: ___________________________
Subscribed and sworn to before me by
of legal age,
,
and resident of
personally known to me this
day of
of 20
, at
.
___________________________
Notary Public
A filing fee of $150.00 as required by Section 6.7.2 (b) of the Regulation under the Uniform Securities Act of Puerto
Rico must accompany this application in the form of check or money order drawn to the “Secretary of the Treasury”
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