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Appointment And Application For Registration As Agent R8 - Puerto Rico

Appointment And Application For Registration As Agent Form. This is a Puerto Rico form and can be used in Securities Blue Sky Commissioner Of Financial Institutions .
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Form R-8 Rev. 03/13 COMMONWEALTH OF PUERTO RICO COMMISSIONER OF FINANCIAL INSTITUTIONS Centro Europa Building, Suite 600 1492 Ponce de León San Juan, PR 00907-4127 Tel. (787) 723-8403 Fax (787) 724-2604 APPOINTMENT AND APPLICATION FOR REGISTRATION AS AGENT Securities Regulation Division Office of the Commissioner of Financial Institutions San Juan, Puerto Rico The undersigned Issuer Name Street/Address City State hereby certifies that it Has __________________________________________________________________ employed as its agent under the provisions of the Uniform Securities Act. Dated and signed this day of , Year . _______________________________________________ Name of Issuer By: ____________________________________ Name and Title American LegalNet, Inc. www.FormsWorkFlow.com
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