Missouri > Secretary Of State > Blue Sky > Securities
State Covered Investment Adviser Affidavit SADV1 - Missouri
| State Covered Investment Adviser Affidavit Form. This is a Missouri form and can be used in Securities Blue Sky Secretary Of State . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
Robin Carnahan Secretary of State State of Missouri Securities Division · 600 W. Main · PO Box 1276 Jefferson City, MO 65102 State Covered Investment Adviser Affidavit I, , do hereby swear and affirm that I am a principal of ("the applicant") and I hereby make the following representation on behalf of the applicant, after having thoroughly searched all applicable records that: Designation of Chief Compliance Officer: The Chief Compliance Officer named below has applied for registration and meets the examination requirements specified in MO 15 CSR 30-51.030(2)(C) and will serve in the capacity of Chief Compliance Officer for the applicant. ____________________________________________ Name (Mark only one of the three boxes below) The applicant has never had any clients that reside in the State of Missouri. The applicant has maintained accounts for the following clients (attach a list of names, addresses, and telephone numbers of all Missouri clients, as well as the date each account was opened): ____________________________________________ CRD Number The applicant has been registered as an investment adviser with the Securities and Exchange Commission and has been conducting business in Missouri as a federal covered adviser. Applicant became ineligible for federal registration on and will not conduct advisory business in Missouri until it has received registration as a state covered adviser. (Principal's Signature) Subscribed and sworn to before me this day of 20 (Notary Public) My Commission expires: FORM SADV-1 (03-11) American LegalNet, Inc. www.FormsWorkFlow.com
|
|||||||
