Form Adv-W - Notice Of Withdrawal From Registration As An Investment Adviser (Page 3 of 11) in pdf

Instructions for Form ADV-W

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b. After I withdraw from registration, only one person will have custody of my books and records, but

they will be kept at three locations (Locations X, Y and Z). How should I complete the Schedule W1?

You would complete three Schedules W1. The first would list the person that will have custody of

your books and records, and Location X. The second Schedule W1 would list (again) the person that

has or will have custody of your books and records, and Location Y. The third Schedule W1 would

list (again) the person that has or will have custody of your books and records, and Location Z.

c. After I withdraw from registration, two people (Persons A and B) will have custody of my books and

records, and my books and records will be kept at two locations (Locations Y and Z). Each person

would have custody of the books and records that are kept at both locations. How should I complete

the Schedule W1?

You would complete four Schedules W1. The first would list Person A and Location Y. The second

Schedule W1 would list (again) Person A, and would list Location Z. The third Schedule W1 would

list Person B and Location Y, and the fourth Schedule W1 would list Person B and Location Z. On

each Schedule W1, you should briefly describe the records that are kept at each location (e.g.,

business and trading records from 1996 through 1999).

Who should sign the Form ADV-W?

Copies of the Form ADV-W you file with the SEC must be executed by a person you have authorized to

file the Form. If you are a sole proprietor, you must sign the Form; if you are a partnership, a general

partner must sign the Form in the name of the partnership; if you are an unincorporated organization or

association that is not a partnership, the managing agent (an authorized person who directs or manages

or who participates in the directing or managing of its affairs) must sign the Form in the name of the

organization or association; if you are a corporation, a principal officer duly authorized must sign the

Form in the name of the corporation. If an officer of any entity is signing the Form, the officer’s title must

be given.

What if I need more space to provide additional information?

If you are filing electronically, add any additional information in the text box asking you to “describe the

books and records kept at this location.” If you are filing on paper, use the reverse side of Schedule W1

to provide any additional information.

10. What if I do not follow these instructions when completing the Form ADV-W?

If you do not prepare and execute the Form ADV-W as required by these instructions, SEC staff may

return the form to you for correction. The SEC’s acceptance of the Form, however, is not a finding that

you have filed the Form ADV-W as required or that the information submitted is true, correct or complete.

PRIVACY ACT STATEMENT. Section 203(h) of the Advisers Act [15 U.S.C. §80b-3(h)] authorizes the Commission to collect the

information required by Form ADV-W. The Commission collects this information for regulatory purposes, such as reviewing an adviser’s

application to withdraw. Filing Form ADV-W is mandatory for an investment adviser to withdraw from registration. The Commission

maintains the information submitted on Form ADV-W and makes it publicly available. The Commission may return forms that do not include

required information. Intentional misstatements or omissions constitute federal criminal violations under 18 U.S.C. §1001 and 15 U.S.C. §80b-

17. The information contained in Form ADV-W is part of a system of records subject to the Privacy Act of 1974, as amended. The

Commission has published in the Federal Register the Privacy Act System of Records Notice for these records.

SEC’S COLLECTION OF INFORMATION. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of

information unless it displays a currently valid control number. Section 203(h) of the Advisers Act authorizes the Commission to collect the

information on this Form from applicants. See 15 U.S.C. §80b-3(h). Filing of this Form is mandatory for an investment adviser to withdraw

Form Adv-W - Notice Of Withdrawal From Registration As An Investment Adviser Page 3