Fillable Risk Assessment Report For Brokers And Dealers For 17h (Page 2 of 6) in pdf

GENERAL INSTRUCTIONS

1. This Form consists of two parts. Part I consists of the organizational, policy and legal information required

by paragraphs (a)(1)(i) through (iii) of section 240.17h-1T, together with the financial statements required by

paragraphs (a)(1)(iv) and (v) of section 240.17h-1T. Part II contains line items for reporting the numerical and

other data required by paragraphs (a)(1)(vi) through (x) of section 240.17h-1T.

2. Report as of the last day of the fiscal quarter. This Form is to be filed within 60 calendar days of the end of

each fiscal quarter by brokers and dealers concerning each Material Associated Person (as defined in Temporary

Rules 17h-1T and 17h-2T). The Form for the fourth fiscal quarter shall be filed within 60 calendar days of the

end of the fiscal year. The cumulative year-end financial statements required by paragraphs (a)(1)(iv) and (v)

of section 240.17h-1T may be filed separately within 105 calendar days of the end of the fiscal year.

3. In the event a broker or dealer is associated with one or more other registered brokers or dealers, each broker

or dealer is required to file a separate Form 17-H. The Commission may exempt from the filing requirements

all brokers or dealers associated with a broker or dealer that has been designated a “Reporting Broker or Dealer.”

The term “Reporting Broker or Dealer” shall have the meaning set forth in Rules 17h-1T and 17h-2T. A broker

or dealer seeking designation as a Reporting Broker or Dealer must apply to the Commission for an exemption

pursuant to Rule 17h-2T. Pending such designation, each broker or dealer associated with the broker or dealer

requesting such designation as a Reporting Broker or Dealer is required to file a separate Form 17-H.

4. The information requested in Part II of this Form shall be completed separately for each Material Associated

Person, even if the financial data contained in the broker or dealer’s Form X-17A-5 contains information

concerning a Material Associated Person. The broker-dealer should not include information concerning its

activities in the information required by Part II of this Form if such information is filed with the Commission as

part of the broker-dealer’s Form X-17A-5 or Form G-405.

ITEM 1

ORGANIZATIONAL CHART REFLECTING ASSOCIATED PERSONS AND THE BROKER-DEALER

1. Provide a copy of the organizational chart maintained by the broker or dealer pursuant to paragraph (a)(1)(i)

of section 240.17h-1T.

2. The information provided pursuant to this Item should be included in the first Form 17-H filed by the broker

or dealer and in the year-end filing. Quarterly updates should be provided only where a material change in the

information provided to the Commission has occurred.

ITEM 2

RISK MANAGEMENT AND OTHER POLICIES

1. Provide copies of the financing, capital adequacy, and risk management and other policies, procedures or

systems maintained by the broker-dealer pursuant to paragraph (a)(1)(ii) of section 240.17h-1T.

2. The information provided pursuant to this Item should be included in the first Form 17-H filed by the broker

or dealer. Quarterly updates should be provided only where a material change in the information provided to the

Commission has occurred.

ITEM 3

LEGAL PROCEEDINGS

1. Provide the description of any material pending legal or arbitration proceedings maintained by the broker or

dealer pursuant to paragraph (a)(1)(iii) of section 240.17h-1T.

2. The information provided pursuant to this Item should be included in the first Form 17-H filed with the

Commission. Quarterly updates should be provided only where a material change in the information provided

to the Commission has occurred.

ITEM 4

FINANCIAL STATEMENTS

1. Provide the information required to be maintained by the broker or dealer pursuant to paragraphs (a)(1)(iv)

and (a)(1)(v) of section 240.17h-1T. The financial statements may be presented on an unaudited basis. The

statement of cash flows and the notes to financial statements may be omitted for the consolidating financial

statements. Entities using accounting principles other than U.S. GAAP should indicate in a note the accounting

principles used.

2. The consolidating financial statements must be presented on a subsidiary basis and shall indicate which

subsidiaries are Material Associated Persons.

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Risk Assessment Report For Brokers And Dealers For 17h Page 2

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