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Form ADV-NR (Paper Version) 

APPOINTMENT OF AGENT FOR SERVICE OF PROCESS BY NON-RESIDENT 

GENERAL PARTNER AND NON-RESIDENT MANAGING AGENT OF AN 

INVESTMENT ADVISER 

You must submit this Form ADV-NR if you are a non-resident general partner or a non-resident 

managing agent of any investment adviser (domestic or non-resident). Form ADV-NR must be 

signed and submitted in connection with the adviser’s initial Form ADV submission. If the 

mailing address you list below changes, you must file an amended Form ADV-NR to provide the 

current address. If you become a non-resident general partner or a non-resident managing agent 

after the date the adviser files its initial Form ADV, you must file Form ADV-NR with the 

Commission within 30 days of the date that you became a non-resident general partner or a nonresident managing agent. If you serve as a general partner or managing agent for multiple 

advisers, you must submit a separate Form ADV-NR for each adviser. 

1. Appointment of Agent for Service of Process 

By signing this Form ADV-NR, you, the undersigned non-resident general partner or nonresident managing agent, irrevocably appoint each of the Secretary of the SEC, and the Secretary 

of State, or equivalent officer, of the state in which the adviser referred to in this form maintains 

its principal office and place of business, if applicable, and any other state in which the adviser is 

applying for registration, amending its registration, or submitting a notice filing, as your agents 

to receive service, and agree that such persons may accept service on your behalf, of any notice, 

subpoena, summons, order instituting proceedings, demand for arbitration, or other process or 

papers, and you further agree that such service may be made by registered or certified mail, in 

any Federal or State action, administrative proceeding or arbitration brought against you in any 

place subject to the jurisdiction of the United States, if the action, proceeding or arbitration: (a) 

arises out of any activity in connection with the investment adviser’s business that is subject to

the jurisdiction of the United States, and (b) is founded, directly or indirectly, upon the 

provisions of: (i) the Securities Act of 1933, the Securities Exchange Act of 1934, the Trust 

Indenture Act of 1939, the Investment Company Act of 1940, or the Investment Advisers Act of 

1940, or any rule or regulation under any of these acts, or (ii) the laws of the state in which the 

adviser referred to in this Form maintains its principal office and place of business, if applicable, 

or of any state in which the adviser is applying for registration, amending its registration, or 

submitting a notice filing. 

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________________________________________________________________________ 

________________________________________________________________________ 

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FORM ADV-NR PAGE 2 

2. Appointment and Consent: Effect on Partnerships 

If you are organized as a partnership, this irrevocable power of attorney and consent to service of 

process will continue in effect if any partner withdraws from or is admitted to the partnership, 

provided that the admission or withdrawal does not create a new partnership. If the partnership 

dissolves, this irrevocable power of attorney and consent shall be in effect for any action brought 

against you or any of your former partners. 

Signature 

I, the undersigned non-resident general partner or non-resident managing agent, certify, under 

penalty of perjury under the laws of the United States of America, that the information contained 

in this Form ADV-NR is true and correct and that I am signing this Form ADV-NR as a free and 

voluntary act. 

Signature of Partner or Agent: 

_____________________________________ Date: _________________________ 

Printed Name: ____________________________ Title: _________________________ 

Mailing Address of Partner or Agent (no P.O. Boxes): 

Signature of Investment Adviser: 

_________________________________ Date: _______________________________ 

Printed Name: ________________________ Title: _______________________________ 

Adviser SEC File Number: 801-__________ or 802-__________ 

Adviser CRD Number: _________________ 

Adviser Name: 

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FORM ADV-NR PAGE 3 

PRIVACY ACT STATEMENT. Section 211(a) of the Advisers Act [15 U.S.C. § 80b-11(a)] 

authorizes the Commission to collect the information required by Form ADV-NR. The Commission 

collects this information to ensure that a non-resident general partner or managing agent of an 

investment adviser appoints an agent for service of process in the United States. Filing Form ADVNR is mandatory for non-resident general partners and non-resident managing agents of investment 

advisers. The Commission maintains the information submitted on Form ADV-NR 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-NR 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 211(a) of the Advisers Act authorizes the Commission to collect the information on 

this Form from applicants. See 15 U.S.C. § 80b-11(a). Filing of this Form is mandatory for nonresident general partners or managing agents of investment advisers. The principal purpose of this 

collection of information is to ensure that a non-resident general partner or managing agent of an 

investment adviser appoints an agent for service of process in the United States. The Commission 

will maintain files of the information on Form ADV-NR and will make the information publicly 

available. Any member of the public may direct to the Commission any comments concerning the 

accuracy of the burden estimate on page one of Form ADV-NR, and any suggestions for reducing 

this burden. This collection of information has been reviewed by the Office of Management and 

Budget in accordance with the clearance requirements of 44 U.S.C. § 3507. 

SEC 2565 (08-22)