FORM MA-W 

NOTICE OF WITHDRAWAL FROM REGISTRATION AS A MUNICIPAL ADVISOR

Please refer to the General Instructions for forms in the MA series before completing this form. All italicized terms 

herein are defined or described in the Glossary of Terms appended to the General Instructions.

A municipal advisor must complete this Form MA-W to withdraw its municipal advisor registration with the SEC. 

WARNING: Complete this form truthfully. False statements or omissions may result in administrative or civil 

action or criminal prosecution. 

Item 1 Identifying Information

A. Full Legal Name:

The name entered here must be the same as the name entered on the registrant’s most recent Form MA. Do

not report a name change on this Form MA-W.

______________________________________________________________________________

B. SEC File Number: ______________

Item 2 Contact Person (for Municipal Advisory Firms) 

The registrant’s contact person must be a principal or employee (not outside counsel) of the municipal advisor 

authorized to receive information and respond to questions about this Form MA-W. 

Name, title, and contact information:

________________________________________________________________ 

(name) (title)

________________________________________________________________ 

(number and street)

________________________________________________________________ 

(city) (state) (country) (postal code)

___________________________________ 

(area code) (telephone number)

_____________________________@______________

(E-mail address)

Item 3 Money Owed to Clients

Has the registrant: 

A. Received any pre-paid municipal advisory fees for municipal advisory activities, including subscription fees

for publications, that have not been delivered? Yes No

If “yes,” what is the amount owed for these pre-paid services (including subscriptions)? $_______.00

B. Borrowed any money from clients that has not been repaid? Yes No

If “yes,” what is the amount owed for these borrowed funds? $_______.00

OMB APPROVAL

OMB Number: 3235-0681

Expires: October 31, 2026

Estimated average burden hours 

per response. . . . . . . . . . . . . . . . 0.5

SEC 2901 (4/14)
2 

Item 4 Advisory Contract Assignments 

Has the registrant assigned any municipal advisory contracts to another person that engages in municipal 

advisory activities? Yes No 

 

If yes, list on Section 4 of Schedule W1 each person to whom the registrant has assigned any such municipal 

advisory contracts and provide the requested information. 

Item 5 Judgments and Liens

Are there any unsatisfied judgments or liens against the registrant? Yes No

Item 6 Books and Records 

NOTE: Rule 15Ba1-8 under the Exchange Act requires a municipal advisor to preserve its books and records 

after the municipal advisor ceases to conduct or discontinues business as a municipal advisor. 

Provide in Schedule W1 the name and address of each person who has or will have custody or possession of 

the municipal advisor’s books and records and each location at which any of such books and records are or will 

be kept.

Item 7 Statement of Financial Condition 

If registrant answered “yes” to Item 3A, Item 3B, or Item 5, complete Schedule W2, disclosing the nature and 

amount of the registrant’s assets and liabilities and net worth as of the last day of the month prior to the filing 

of this Form MA-W. 
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Execution 

For a Sole Proprietor:

I, the undersigned, certify, under penalty of perjury under the laws of the United States of America, that the information 

and statements made in this Form MA-W, including exhibits and any other information submitted, are true. I further 

certify that the books and records of my municipal advisor-related business will be preserved and available for 

inspection as required by law, and that all information submitted on my most recent Form MA and Form MA-I is 

accurate and complete as of this date. I understand that if any information contained in this Form MA-W is different 

from the information contained on my Form MA and Form MA-I, the information on this Form MA-W will replace the 

corresponding entry on my Form MA and Form MA-I. Finally, I authorize any person having custody or possession of 

these books and records to make them available to authorized regulatory representatives.

Signature: _________________________________ Date: __________________________ 

Printed Name: _________________________________ Title: __________________________ 

For a Municipal Advisory Firm: 

I, the undersigned, have signed this Form MA-W on behalf of, and with the authority of, the municipal advisor

withdrawing its registration. The advisor and I both certify, under penalty of perjury under the laws of the United States 

of America, that the information and statements made in this Form MA-W, including exhibits and any other information 

submitted, are true. I further certify that the municipal advisor’s books and records will be preserved and available for 

inspection as required by law, and that all information submitted on the municipal advisor’s most recent Form MA is 

accurate and complete as of this date. The municipal advisor and I understand that if any information contained in this 

Form MA-W is different from the information contained on Form MA, the information on this Form MA-W will 

replace the corresponding entry on the municipal advisor’s Form MA. Finally, I authorize any person having custody

or possession of these books and records to make them available to authorized regulatory representatives.

Signature: _________________________________ Date: __________________________ 

Printed Name: _________________________________ Title: __________________________ 
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FORM MA-W Schedule W1 

Certain items in Form MA-W may require additional information on this Schedule W1. Use this Schedule W1 to report details for 

items listed below. Report only new information or changes/updates to previously submitted information. Do not repeat previously 

submitted information.

SECTION 4 Advisory Contract Assignments

Check here if this section is being completed: 

Complete the following information for each person to whom the registrant has assigned any advisory contract to provide municipal 

advisor-related services. Complete a separate Schedule W1 for each person to whom the registrant has assigned such a contract.

Name and business address of the person to whom advisory contracts were assigned: 

 _____________________________________________________________________________________________________ 

(name)

 _____________________________________________________________________________________________________ 

(number and street)

 _____________________________________________________________________________________________________ 

(city) (state) (country) (postal code)

 ______________________________________ 

(area code) (telephone number)

Is this address a private residence? Yes No 

SECTION 6 Books and Records

Person with Custody

Complete the following information for the person that has or will have custody or possession of the books and records kept at the 

location described in this Section 6 of this Schedule. A separate Schedule W1 must be completed for each person that has or will 

have custody of any of the registrant’s books and records. If the person listed below has or will have custody of any of the 

registrant’s books and records at any other location, a separate Schedule W1 must be completed listing this person and each other 

location where the person has custody of the registrant’s books and records.

_____________________________________________________________________________________________________ 

(name)

 _____________________________________________________________________________________________________ 

(number and street)

 _____________________________________________________________________________________________________ 

(city) (state) (country) (postal code)

 ______________________________________ 

(area code) (telephone number)

Is this address a private residence? Yes No 

Location 

Complete the following information for the location where the books and records of which the person listed in this Section 6 of this 

Schedule has or will have custody or possession. A separate Schedule W1 must be completed for each location at which the 

registrant’s records are or will be kept. If any other person has or will have custody or possession of any of the books and records at 

the location described below, a separate Schedule W1 must be completed listing this location and each other person that has or will 

have custody of the registrant’s books and records.

_____________________________________________________________________________________________________ 

(name)

 _____________________________________________________________________________________________________ 

(number and street)

 _____________________________________________________________________________________________________ 

(city) (state) (country) (postal code)

 ______________________________________ 

(area code) (telephone number)

Is this address a private residence? Yes No 

 Briefly describe the books and records kept at this location. ___________________________________________
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FORM MA-W Schedule W2

If the registrant answered “yes” to Item 3A, 3B, or 5 of Form MA-W, complete this Schedule W2. This balance sheet must be 

prepared in accordance with generally accepted accounting principles, but need not be audited.

SECTION 7 STATEMENT OF FINANCIAL CONDITION

I. Assets

Current Assets

 Cash ___________________________ 

 Securities at Market ___________________________ 

 Non-Marketable Securities ___________________________ 

 Other Current Assets ___________________________ 

 Total Current Assets $ __________________________

Fixed Assets

 Total Fixed Assets $ __________________________

 

TOTAL ASSETS $ 

II. Liabilities & Shareholders’ Equity

Current Liabilities

 Prepaid Advisory Fees ___________________________ 

 Short-Term Loans from Clients ___________________________ 

 Other Short-Term Loans ___________________________ 

 Other Current Liabilities ___________________________ 

 Total Current Liabilities $ __________________________ 

Fixed Liabilities

 Long-Term Debt Owed to Clients ___________________________ 

 Other Long-Term Debt ___________________________ 

Other Long-Term Liabilities ___________________________ 

 Total Fixed Liabilities $ __________________________

Shareholders’ Equity

 Total Shareholders’ Equity (or Deficit) $ __________________________

 

TOTAL LIABILITIES AND SHAREHOLDERS’ EQUITY $