FORM MA

APPLICATION FOR MUNICIPAL ADVISOR REGISTRATION

ANNUAL UPDATE OF MUNICIPAL ADVISOR REGISTRATION 

AMENDMENT OF A PRIOR APPLICATION FOR REGISTRATION 

Please read the General Instructions for this form and other forms in the MA series, as well as its subsection, “Specific 

Instructions for Certain Items in Form MA,” before completing this form. All italicized terms herein are defined or described 

in the Glossary of Terms appended to the General Instructions. 

PART I 

This form must be completed by municipal advisors that are organized entities, including sole proprietors (referred 

to herein as “municipal advisory firms” or “firms,” unless the context indicates otherwise). 

WARNING: Complete this form truthfully. False statements or omissions may result in denial of 

application, revocation of registration, administrative or civil action, or criminal 

prosecution. Form MA must be amended promptly upon the occurrence of certain 

material events, and updated at least annually, within 90 days of the end of the 

municipal advisor’s fiscal year, or, if a sole proprietor, the municipal advisor’s calendar 

year. See General Instruction 8. 

Type of Filing: This is an (check the appropriate box): 

Initial application to register as a municipal advisor with the SEC. 

Execution Page: After completing this form, you must complete the Execution Page.

Supporting Documentation: If you are required to make reportable disclosures in the Disclosure Reporting 

Pages, you must attach the supporting documentation. 

Non-Resident Applicants: If you are a non-resident of the United States, certain additional requirements must 

be met at the time of filing your application, or processing of your application may be delayed. See General 

Instruction 2.c. and subsection “General Instructions to Form MA-NR” of the General Instructions. 

Annual update of municipal advisor’s Form MA, for fiscal year ended ______, or, if a sole proprietor, for 

calendar year ended December 31, _____. 

Execution Page: After completing this form, you must complete the Execution Page.

Changes: Are there changes in this annual update to information provided in the municipal advisor’s most 

recent Form MA, other than the updated Execution Page?

Yes No 

Amendment (other than annual update) to any part of the municipal advisor’s most recent Form MA. 

Execution Page: After completing this form, you must complete the Execution Page.

OMB APPROVAL

OMB Number: 

Expires: 

 3235-0681

October 31, 2026

per initial response. . . . . . . . . . . 3.5

Estimated average burden hours 

per annual amendment. . . . . . . 1.5

per other amendment . . . . . . . . 0.5
Item 1 Identifying Information 

 

A. Full Legal Name of the Firm:

(1) Firm Name: ______________________________________________________

Organization CRD No., if any: _____________

(2) Sole Proprietor: If the applicant is a sole proprietor, check the box below, and provide full last name, 

first name, middle name, and suffix, if any:

Enter all the letters of each name and not initials or other abbreviations. If no middle name, enter 

NMN on that line.

 __________________ _______________ _____________ ________ 

Last Name First Name Middle Name Suffix

 

Individual CRD No., if any: _____________

(3) Name Change: If full legal name has changed since the municipal advisor’s most recent Form MA, 

check here and provide the previous full legal name. 

 ______________________________________________ 

B. Doing-Business-As (DBA) Name:

(1) If the name under which municipal advisor-related business is primarily conducted is different from 

Item 1-A., check here and provide the DBA name. 

________________________________________________________________________ 

 

(2) Previous DBA Name: 

If name under which municipal advisor-related business is primarily conducted has changed since the 

municipal advisor’s most recent Form MA, check here and provide the previous name under which the 

municipal advisor-related business was primarily conducted. 

 _________________________________________ 

(3) Additional Names: 

(a) Is municipal advisor-related business conducted under any additional names? Yes

No

(b) If “Yes,” list any additional names on Section 1-B of Schedule D. 

C. (1) IRS Employer Identification Number: ______________________________ 
D. Registrations 

 

(1) Form MA-T Registration: Was the applicant previously registered on Form MA-T as a municipal 

advisor? 

Yes If “Yes,” enter the SEC File No. MA-T: ______________ 

No

 

(2) Other Registrations: Is the applicant registered as or with any of the following? 

 

Check all that apply. For each registration box you check, provide the requested file number(s). An

applicant firm should NOT provide the organization CRD number, or other specified number, of any of its 

organizational affiliates, or the individual CRD number of its officers, employees, or natural person 

affiliates. 

 

Municipal Advisor SEC File No.: _________ 

Municipal Securities Dealer SEC File No.: _________ 

Broker-Dealer SEC File No.: _________ Organization CRD No.: ___________

Investment Adviser

SEC-Registered SEC File No.: ________ Organization CRD No.: ___________

 Exempt Reporting Adviser SEC File No.: ________ Organization CRD No.: ___________

Investment Adviser Registration in a US State or Other US Jurisdiction: If applicant is registered 

in a US state or other jurisdiction as an investment adviser, check the Registered in US State or 

Other US Jurisdiction box below and enter the organization CRD Number. In the table below, 

check the box for each US state or jurisdiction in which the applicant is so registered.

Registered in US State or Other US Jurisdiction Organization CRD No. ___________ 

 

Check 

All 

That 

Apply 

US

State or 

Jurisdiction Code

Check 

All 

That 

Apply 

US

State or 

Jurisdiction Code

Alabama AL Montana MT

Alaska AK Nebraska NE

Arizona AZ Nevada NV

Arkansas AR New Hampshire NH

California CA New Jersey NJ

Colorado CO New Mexico NM

Connecticut CT New York NY

Delaware DE North Carolina NC

District of Columbia DC North Dakota ND

Florida FL Ohio OH

Georgia GA Oklahoma OK

Guam GU Oregon OR

Hawaii HI Pennsylvania PA

Idaho ID Puerto Rico PR

Illinois IL Rhode Island RI

Indiana IN South Carolina SC

Iowa IA South Dakota SD

Kansas KS Tennessee TN

Kentucky KY Texas TX
Louisiana LA Utah UT

Maine ME Vermont VT

Maryland MD Virgin Islands VI

Massachusetts MA Virginia VA

Michigan MI Washington WA 

Minnesota MN West Virginia WV 

Mississippi MS Wisconsin WI 

Missouri MO

Government Securities Broker-Dealer 

SEC File No.: _______________ Bank Identifier: _______________ 

Other SEC Registration (Specify): __________________________________ 

SEC File No. (if any): ___________ EDGAR CIK (if any): __________

Another federal or state regulator (Specify): ___________________________ 

Registration No. (if any): ___________ 

 

(3) Additional Registrations

(a) Does the applicant have any additional registrations that are not listed in subsection (2)? 

 

 

Yes No

(b) If “Yes,” list such additional registrations on Section 1-D of Schedule D. 

E. Principal Office and Place of Business 

(1) Address: (Do not use a P.O. Box.) 

______________________________________________________________________ 

(number and street)

______________________ _________ ___________ _____________________ 

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

______________________________________ ________________________________ 

Telephone number at this location Fax number (if any) at this

location 

(area code) (telephone number) (area code) (fax number)

For non-US telephone and fax numbers, include country code with area code and local number.

If this address is a private residence, check this box: 

A private residential address will not be included in publicly available versions of this registration form.

(2) Additional Offices:

(a) Is municipal advisor-related business conducted at any office(s) other than applicant’s principal 

office and place of business listed above? 

 Yes No

 

(b) If “Yes,” list the five largest such additional offices on Section 1-E of Schedule D. 
(3) Mailing Address:

Complete this item only if mailing address is different from principal office and place of business address in Item 

1-E.(1): 

______________________________________________________________________ 

(number and street)

_______________________ _________ ___________ _____________________ 

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

If this address is a private residence, check this box: 

A private residential address will not be included in publicly available versions of this registration form.

F. Website

(1) Provide the address of the applicant’s principal website (if any): 

(specify) _______________________________________________

(2) Does the applicant have additional websites? 

 Yes No

(3) If “Yes,” how many? 

(specify) ____

If “Yes,” list all additional website addresses on Section 1-F of Schedule D. 

G. If the applicant has a Chief Compliance Officer, provide his or her name and contact information: 

Please note that the applicant must provide name and contact information for either a Chief Compliance 

Officer in this Question 1-G., or another contact person in Question 1-H below. Both may be provided. 

Enter all the letters of each name and not initials or other abbreviations. If no middle name, enter 

NMN on that line.

 _______________ _______________ _______________ 

Last Name First Name Middle Name

______________________________________________________________________ 

(other title(s), if any) 

______________________________________________________________________ 

(number and street)

_______________________ _________ ___________ ____________________ 

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

______________________________________ ______________________________ 

(area code) (telephone number) (area code) (fax number)

For non-US telephone and fax numbers, include country code with area code and local number.

If this address is a private residence, check this box: 

A private residential address will not be included in publicly available versions of this registration form.

_________________@_________________ 

(E-mail address of Chief Compliance Officer) 
H. Contact Person: If a person other than the Chief Compliance Officer is authorized to receive information 

and respond to questions about this form, provide the name and contact information for that person: 

 

Please note that the applicant must provide name and contact information for either a Chief Compliance 

Officer in Question 1-G. above, or another contact person in this Question 1-H. Both may be provided. 

 

Enter all the letters of each name and not initials or other abbreviations. If no middle name, enter 

NMN on that line.

 _______________ _______________ _______________ 

Last Name First Name Middle Name

______________________________________________________________________ 

(other title(s), if any) 

______________________________________________________________________ 

(number and street) 

_______________________ _________ ___________ ____________________ 

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

______________________________________ ______________________________ 

(area code) (telephone number) (area code) (fax number)

For non-US telephone and fax numbers, include country code with area code and local number.

If this address is a private residence, check this box: 

A private residential address will not be included in publicly available versions of this registration form.

_________________@________________ 

(E-mail address of Contact Person) 

I. Location of Books and Records 

(1) Does the applicant maintain, or intend to maintain, some or all of the books and records required to be 

kept under MSRB rules and SEC rules at a location other than the principal office and place of business 

address listed in Item 1-E? 

 Yes No

(2) If “Yes,” list all such locations in Section 1-I of Schedule D. 

 

J. Foreign Financial Regulatory Authorities

(1) Is the applicant registered with a foreign financial regulatory authority? Answer “no” even if affiliated 

with a business that is registered with a foreign financial regulatory authority. Yes

No

(2) If “Yes,” list all such registrations in Section 1-J of Schedule D. 

K. Business Affiliates of the Applicant

(1) Is the applicant affiliated with any other domestic or foreign business entity? 

Yes No

(2) If “Yes,” provide the names of all such affiliates and any applicable registrations in Section 1-K of 

Schedule D. 
Item 2 Form of Organization 

 

A. Applicant’s Form of Organization 

 

If this is not an initial application, and the applicant’s form of organization has changed since the 

applicant’s most recent Form MA, see Instruction 8 of the General Instructions. 

 Corporation Sole Proprietorship Limited Liability Partnership (LLP) 

 Partnership Limited Liability Company (LLC) Limited Partnership (LP) 

Other (specify):_______________________________________________________________ 

 

B. Month of Applicant’s Annual Fiscal Year End ___________________ 

(Sole proprietors are not required to complete this subpart B.)

 

C. State, Other US Jurisdiction, or Foreign Jurisdiction Under Which Applicant is Organized 

 

If the applicant is a corporation or limited liability company, indicate the state or jurisdiction where the 

applicant is incorporated. If the applicant is a partnership, indicate the name of the state or jurisdiction 

under the laws of which the partnership was formed. If applicant is a sole proprietor, indicate the state or 

jurisdiction in which applicant resides. 

If this is not an initial application for registration, and the applicant’s information has changed since the 

applicant’s most recent Form MA, see General Instruction 8.

Enter the full name of the state or other US jurisdiction, or the full name, in English, of the foreign 

jurisdiction: _________________________________________ 

D. Date of Organization: ___________________ 

 

E. Public Reporting Company 

(1) Is the applicant a public reporting company under Sections 12 or 15(d) of the Securities 

Exchange Act of 1934? 

 Yes No

 

(2) If “Yes,” provide applicant’s EDGAR CIK number: _____________ 

Item 3 Successions 

 

A. Is the applicant, at the time of this filing, succeeding to the business of a registered municipal advisor? 

If this succession was previously reported on Form MA, do not report the succession again. Instead, check “No.” 

See Instruction 1 of the Specific Instructions for Certain Items in Form MA included in the General Instructions. 

Yes If “Yes,” enter the Date of Succession: ______________ 

 

 (mm/dd/yyyy)

No

B. If “Yes” in Item 3-A., complete Section 3 of Schedule D. 
Item 4 Information About Applicant’s Business 

Note: Instruction 2 of the Specific Instructions for Certain Items in Form MA included in the General 

Instructions provides guidance for newly formed municipal advisors completing this Item 4. 

 

Employees 

If the applicant is organized as a sole proprietorship, include the sole proprietor as an employee. 

 

A. Number of Employees: Approximate number of employees of applicant. Include full- and part-time 

employees, but do not include clerical, administrative, or support workers (or workers performing similar 

functions): _____________ (If none, enter a zero.) 

B. Municipal Advisory Activities: Approximately how many of these employees engage in municipal 

advisory activities? (Include such employees even if they perform other functions in addition to engaging 

in municipal advisory activities.) _____________ (If none, enter a zero.) 

C. Registered Representatives

(1) Approximately how many of the employees who are included in the response to part B are registered 

representatives of a broker-dealer? _______________ (If none, enter a zero.) 

(2) Approximately how many are investment adviser representatives? ______________ (If none, enter a 

zero.)

D. Firms and Other Persons that Solicit on Behalf of the Applicant 

Approximately how many firms and other persons who are not employed by the applicant and who are not 

otherwise associated persons of the applicant solicit clients on the applicant’s behalf? (Count a firm only 

once; do not count each of the firm’s employees that solicits on the applicant’s behalf.)

 

___________ (If none, enter a zero.) 

Please list the names of these firms and other persons on Section 4-D of Schedule D. 

E. Employees Also Acting as Affiliates of the Applicant

 

(1) Does the applicant have any employees that also do business independently on the applicant’s behalf as 

affiliates of the applicant? 

 Yes No 

(2) If “Yes,” provide the total number of such employees: _______

(3) List the names of these employees on Section 4-E of Schedule D. 

 
Clients 

 

F. Types of Clients: Approximately how many clients did the applicant serve in the context of its municipal 

advisory activities during its most-recently completed fiscal year? ___________ (If none, enter a zero and 

check box 5 below.)

The applicant has the following types of clients:

Check all that apply. 

(1) Municipal entities 

(2) Non-profit organizations (e.g., 501(c)(3) organizations) who are obligated persons 

(3) Corporations or other businesses not listed above who are obligated persons 

(4) Other: ___________________________ 

(5) Not applicable - applicant engages only in solicitation; does not serve clients in the 

context of

its municipal advisory activities. 

G. Solicitations of Municipal Entities and Obligated Persons

Approximately how many municipal entities and obligated persons were solicited by the applicant on 

behalf of a third-party during its most-recently completed fiscal year? (If the applicant solicits its clients in 

addition to serving these clients in the context of its municipal advisory activities, the clients should be counted in the 

response to this Part G even if counted in Part F.) 

(1) Municipal Entities: ____________ (If none, enter a zero.) 

(2) Obligated Persons: ____________ (If none, enter a zero.) 

(3) Total: _______________ 

 

H. Types of Persons Solicited

 

The applicant solicits the following types of persons: 

Check all that apply. 

(1) Public pension funds 

(2) 529 Plans 

(3) Local government investment pools 

(4) State government investment pools 

(5) Hospitals 

(6) Colleges 

(7) Other: ___________________________ 

(8) Not applicable – applicant only serves clients; does not engage in solicitation in the context 

of 

 its municipal advisory activities.
Compensation Arrangements

 

I. Applicant is compensated for its advice to or on behalf of municipal entities or obligated persons with 

respect to municipal financial products or the issuance of municipal securities by: 

Check all that apply. 

(1) Hourly charges

(2) Fixed fees (not contingent on the issuance of municipal securities) 

(3) Contingent fees

(4) Subscription fees (for a newsletter or other publications)

(5) Other (specify): __________________________________________________ 

(6) Not applicable – applicant engages only in solicitation; does not serve clients in 

the context of

its municipal advisory activities. 

 

J. Applicant is compensated for its solicitation activities by: 

 

Check all that apply.

(1) Hourly charges

(2) Fixed fees (not contingent on the success of solicitations) 

(3) Contingent fees

(4) Subscription fees (for a newsletter or other publications) 

(5) Other (specify): __________________________________________________ 

(6) Not applicable; applicant only serves clients; does not engage in solicitation as part of its 

municipal advisory activities.

K. Does the applicant receive compensation, in the context of its municipal advisory activities, from 

anyone other than clients? 

 Yes No 

 

If “Yes,” please explain: 

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

Applicant’s Business Relating to Municipal Securities 

L. Applicant is engaged in the following types of activities: 

Check all that apply. 

(1) Advice concerning the issuance of municipal securities (including, without limitation, advice 

concerning the structure, timing, terms and other similar matters, such as the preparation of 

feasibility studies, tax rate studies, appraisals and similar documents, related to an offering of 

municipal securities)

(2) Advice concerning the investment of the proceeds of municipal securities (including, 

without limitation, advice concerning the structure, timing, terms and other similar matters 

concerning such investments) 

(3) Advice concerning municipal escrow investments (including, without limitation, advice 

concerning their structure, timing, terms and other similar matters) 

(4) Advice concerning the investment of other funds of a municipal entity (including, without 
limitation, advice concerning the structure, timing, terms and other similar matters concerning 

such investments) 

(5) Advice concerning guaranteed investment contracts (including, without limitation, advice 

concerning their structure, timing, terms and other similar matters) 

(6) Advice concerning the use of municipal derivatives (including, without limitation, advice 

concerning their structure, timing, terms and other similar matters) 

(7) Solicitation of investment advisory business from a municipal entity or obligated person

(including, without limitation, municipal pension plans) on behalf of an unaffiliated broker, 

dealer, municipal advisor or investment adviser (e.g., third party marketers, placement agents, 

solicitors, and finders) 

(8) Solicitation of business other than investment advisory business from a municipal entity or 

obligated person on behalf of an unaffiliated person or firm (e.g., third party marketers, 

placement agents, solicitors, and finders) 

(9) Advice or recommendations concerning the selection of other municipal advisors or 

underwriters with respect to municipal financial products or the issuance of municipal securities 

(10) Brokerage of municipal escrow investments 

(11) Other (specify):____________________________

Item 5 Other Business Activities 

A. Applicant is actively engaged in business in or as a: 

Other Business (i) Is 

Applicant 

Actively 

Engaged?

Check all that 

apply.

(ii) Is this 

Applicant’s 

Primary 

Business(es)? 

 

Check all that 

apply.

(iii) Jurisdiction(s) where licensed:

1. Broker-dealer, municipal securities 

dealer or government securities broker 

or dealer

2. Registered representative of a brokerdealer

3. Commodity pool operator (whether 

registered or exempt from registration)

4. Commodity trading advisor (whether 

registered or exempt from registration) 

5. Futures commission merchant

6. Major swap participant

7. Major security-based swap participant

8. Swap dealer 

9. Security-based swap dealer

10. Trust company

11. Real estate broker, dealer, or agent

12. Insurance company, broker, or agent

13. Banking or thrift institution (including 

a separately identifiable department or 

division of a bank)

14. Investment adviser (including 

financial planners) 
15. Attorney or law firm ________________________________

________________________________

________________________________

16. Accountant or accounting firm ________________________________

________________________________

________________________________

17. Engineer or engineering firm 

18. Other financial product advisor 

(specify):

_________________________ 

_________________________

_________________________

B. Other Business: 

(1) Is applicant actively engaged in any other business not listed in Part A of this Item 

(other than engaging in municipal advisory activities)? 

 Yes No

 

(2) If “Yes” to Part B-1., is this other business applicant’s primary business? 

Yes No

 

(3) If “Yes” to Part B-2., describe the other business on Section 5-B of Schedule D. 

Item 6 Financial Industry and Other Activities of Associated Persons

A. Applicant has one or more associated persons that is a: 

Check all that apply.

“Associated Person” herein refers to a person who is an associated person of a municipal advisor. Note that 

“associated person” includes employees and persons with control over the municipal advisor that do not themselves 

engage in municipal advisory activities, but does not include employees that are performing solely clerical, 

administrative, support or other similar functions. Note also that more than one box may be applicable to any such 

associated person. For example, if an associated person is both a swap dealer and security-based swap dealer, check 

both boxes (4) and (5) below. 

 

(1) Broker-dealer, municipal securities dealer, or government securities broker or dealer

(2) Investment company (including mutual funds) 

(3) Investment adviser (including financial planners)

(4) Swap dealer

(5) Security-based swap dealer 

(6) Major swap participant 

(7) Major security-based swap participant 

(8) Commodity pool operator (whether registered or exempt from registration) 

(9) Commodity trading advisor (whether registered or exempt from registration) 

(10) Futures commission merchant 

(11) Banking or thrift institution

(12) Trust company

(13) Accountant or accounting firm 
(14) Attorney or law firm 

(15) Insurance company or agency 

(16) Pension consultant 

(17) Real estate broker or dealer 

(18) Sponsor or syndicator of limited partnerships 

(19) Engineer or engineering firm 

(20) Other municipal advisor

Total Associated Persons: Provide the total number of all such associated persons: ______ 

Provide the total number of such associated persons, not the number of boxes checked. For example, if the applicant’s 

associated persons are 2 broker-dealers, 1 investment company, and 2 pension consultants, then 3 boxes would be 

checked in Item 6-A.1 to 20, while the total number of such associated persons entered in Item 6-A, Total Associated 

Persons, would be 5. If there are no associated persons, enter 0.

B. Applicant must list all such associated persons, including foreign associated persons, on Section 6 of

Schedule D. 

If Item 6-A, Total Associated Persons, is 2 or more, the applicant must complete a separate Section 6 of Schedule D 

for each associated person. 

Item 7 Participation or Interest of Applicant, or of Associated Persons of Applicant, in Municipal 

Advisory Client or Solicitee Transactions 

 

Proprietary Interest in Municipal Advisory Client or Solicitee Transactions 

 

A. Does applicant or any associated person: 

 

(1) buy securities or other investment or derivative products for itself from clients or solicitees in the 

context of its municipal advisory activities, or sell securities it owns to such clients or solicitees?

 

 

 Yes No 

(2) buy or sell for itself securities (other than shares of mutual funds) or other investment or derivative

products that the applicant also recommends to such clients or solicitees?

Yes No 

 

(3) enter into derivatives contracts with such clients or solicitees? 

 Yes No 

 

(4) recommend securities or other investment or derivative products to such clients or solicitees in which 

applicant or any associated person has some other proprietary (ownership) interest (other than those 

mentioned in Items 7-A(1), (2) or (3) above)? 

 Yes No 

Sales Interest in Client or Solicitee Transactions 

 

B. Does applicant or any associated person: 

 

(1) recommend purchases of securities or derivatives to clients or solicitees that are served by the applicant 

or associated person, for which the applicant or any associated person serves as underwriter, general or 

managing partner, or purchaser representative? 

 Yes No 
 

(2) recommend purchases or sales of securities or derivatives to such clients or solicitees in which 

applicant or any associated person has any other sales interest (other than the receipt of sales 

commissions as a broker or registered representative of a broker-dealer)? 

Yes No 
Investment or Brokerage Discretion 

 

C. Does applicant or any associated person have discretionary authority to determine the: 

(1) securities or other investment or derivative products to be bought or sold for the account of a client or 

solicitee? 

 Yes

No

(2) amount of securities or other investment or derivative products to be bought or sold for the account of 

such a client or solicitee? 

 Yes No 

(3) (a) broker or dealer to be used for a purchase or sale of securities or other investment or derivative 

products for the account of such a client or solicitee? 

 Yes No 

 (b) If “Yes,” are any of the brokers or dealers associated persons?

 Yes No 

 

(4) commission rates or other fees to be paid to a broker or dealer for such a client’s or solicitee’s 

securities transactions or transactions in other investment or derivative products? Yes

No 

 

 

D. (1) Does applicant or any associated person recommend brokers, dealers or investment advisers to 

clients or solicitees in the context of its municipal advisory activities? 

Yes No

 

(2) If “Yes,” is any such broker, dealer, or investment adviser an associated person? Yes

No 

In responding to Items 7-E and 7-F below, consider all cash and non-cash compensation that the applicant or an 

associated person gave or received from any person in exchange for referrals of such clients or solicitees, including any 

bonus that is based, at least in part, on the number or amount of such referrals. 

 

E. Does the applicant or any associated person, directly or indirectly, compensate any person for

referrals of clients or solicitees in connection with municipal advisory activities? Yes

No 

 

F. Does the applicant or any associated person, directly or indirectly, receive compensation from any 

person for referrals of clients or solicitees in connection with municipal advisory activities? 

Yes

No 

Item 8 Owners, Officers, and Other Control Persons 

A. Identifying Owners, Officers, and Other Control Persons 

(1) In this Item, identify every person that, directly or indirectly, controls the applicant, or that the 

applicant directly or indirectly controls. 

 
(a) If this is an initial application, the applicant must complete Schedule A and Schedule B. 

Schedule A asks for information about direct owners and executive officers. 

Schedule B asks for information about indirect owners. 

(b) If this is an amendment updating information reported on either the Schedule A or Schedule B 

(or both) filed with the applicant’s initial application, the applicant must also complete Schedule 

C. 

(2) Does any person not named in Item 1-A or Schedules A, B, or C, directly or indirectly, control the 

applicant’s management or policies? 

 Yes No 

 

(3) If “Yes” to Item 8-A.2. above, complete Section 8-A of Schedule D. 

B. Public Reporting Companies

(1) Is any person in Schedules A, B, or C, or in Section 8-A of Schedule D a public reporting company 

under 

Sections 12 or 15(d) of the Securities Exchange Act of 1934? 

 Yes No 

(2) If “Yes” to Item 8-B.1. above, complete Section 8-B of Schedule D. 

Item 9 Disclosure Information 

 

In this Item, provide information about the criminal, regulatory, and judicial history, if any, of the applicant 

and each associated person of the applicant. 

 

This information is used to determine whether to approve an application for registration, to decide whether to 

revoke registration, or to place limitations on the applicant’s activities as a municipal advisor, and to identify 

potential problem areas on which to focus during on-site examinations. One event may result in the 

requirement to answer “Yes” to more than one question below. 

Refer to the Glossary of Terms for explanations of italicized terms, such as associated person. 

 

Criminal Action Disclosure 

If the answer is “Yes” to any question below in Part A or B below, complete a Criminal Action DRP.

Disclosure of any event listed in this Criminal Action Disclosure section is not required if the date of the event 

was more than ten years ago. For purposes of calculating this ten-year period, the date of an event is the date 

that the final order, judgment, or decree was entered, or the date that any rights of appeal from preliminary 

orders, judgments, or decrees lapsed. 

Check all that apply: 

A. In the past ten years, has the applicant or any associated person: 

 

(1) been convicted of any felony, or pled guilty or nolo contendere (“no contest”) to any charge of a felony, 

in a domestic, foreign, or military court? 

 Yes No

 

(2) been charged with any felony?

 Yes No 
The response to Item 9-A(2) may be limited to charges that are currently pending. 

B. In the past ten years, has the applicant or any associated person: 

(1) been convicted of any misdemeanor, or pled guilty or nolo contendere (“no contest”), in a domestic, 

foreign, or military court to any charge of a misdemeanor in a case involving: municipal advisorrelated business, investments or an investment-related business, or any fraud, false statements, or 

omissions, wrongful taking of property, bribery, perjury, forgery, counterfeiting, extortion, or a 

conspiracy to commit any of these offenses? 

 Yes No

(2) been charged with a misdemeanor of the kind listed in Item 9-B(1)? 

Yes No 

The response to Item 9-B(2) may be limited to charges that are currently pending. 

 

Regulatory Action Disclosure 

If the answer is “Yes” to any question in Parts C-G below, complete a Regulatory Action DRP.

Check all that apply:

 

C. Has the SEC or the CFTC ever:

 

(1) found the applicant or any associated person to have made a false statement or omission? 

 

 

 Yes No 

 

(2) found the applicant or any associated person to have been involved in a violation of any SEC or CFTC 

regulation or statute? 

 Yes No 

(3) found the applicant or any associated person to have been a cause of the denial, suspension, revocation, 

or restriction of the authorization of a municipal advisor-related or an investment-related business to 

operate? 

 Yes

No 

 

(4) entered an order against the applicant or any associated person in connection with municipal advisorrelated or investment-related activity? 

 Yes No 

 

(5) imposed a civil money penalty on the applicant or any associated person, or ordered the applicant or 

any associated person to cease and desist from any activity? 

 Yes No 

D. Has any other federal regulatory agency, any state regulatory agency, or any foreign financial 

regulatory authority ever:

 

(1) found the applicant or any associated person to have made a false statement or omission, or been 

dishonest, unfair, or unethical? 

 Yes No
(2) found the applicant or any associated person to have been involved in a violation of municipal advisorrelated or investment-related regulations or statutes? 

 Yes No

(3) found the applicant or any associated person to have been the cause of a denial, suspension, revocation, 

or restriction of the authorization of a municipal advisor-related or an investment-related business to 

operate? 

 Yes

No

(4) entered an order against the applicant or any associated person in connection with a municipal advisorrelated or investment-related activity? 

 Yes No

(5) denied, suspended, or revoked the registration or license of the applicant or that of any associated 

person, or otherwise prevented the applicant or any associated person, by order, from associating with 

a municipal advisor-related or investment-related business or restricted the activities of the applicant or 

any associated person? 

 Yes No

E. Has any self-regulatory organization or commodities exchange ever: 

 

(1) found the applicant or any associated person to have made a false statement or omission? 

 

 

 Yes No 

(2) found the applicant or any associated person to have been involved in a violation of its rules (other than 

a violation designated as a “minor rule violation” under a plan approved by the SEC)? Yes No 

(3) found the applicant or any associated person to have been the cause of a denial, suspension, revocation 

or restriction of the authorization of a municipal advisor-related or an investment-related business to 

operate? 

 Yes

No 

 

(4) disciplined the applicant or any associated person by expelling or suspending the applicant or the 

associated person from membership, barring or suspending the applicant or the associated person from 

association with other members, or by otherwise restricting the activities of the applicant or the 

associated person? 

 Yes No 

 

F. Revocation or Suspension: Has the applicant or any associated person ever had an authorization to act as 

an attorney, accountant, or federal contractor revoked or suspended? 

 Yes No 

G. Regulatory Proceedings: Is the applicant or any associated person currently the subject of any regulatory 

proceeding that could result in a “Yes” answer to any part of Item 9-C, 9-D, or 9-E? Yes

No 

 

Civil Judicial Disclosure 

 

If the answer is “Yes” to a question below, complete a Civil Judicial Action DRP. 
Check all that apply: 

 

H. (1) Has any domestic or foreign court ever: 

 

(a) enjoined the applicant or any associated person in connection with any municipal advisor-related

or investment-related activity? 

 Yes No

 

(b) found that the applicant or any associated person was involved in a violation of any municipal 

advisor-related or investment-related statute(s) or regulation(s)?⁪ 

Yes No

 

(c) dismissed, pursuant to a settlement agreement, a municipal advisor-related or investment-related 

civil action brought against the applicant or any associated person by a state or other US 

jurisdiction or a foreign financial regulatory authority? 

 Yes No 

 

(2) Current Proceedings: Is the applicant or any associated person the subject of any currently pending 

civil proceeding that could result in a “Yes” answer to any part of Item 9-H(1)? Yes

No 

Item 10 Small Businesses

The SEC is required by the Regulatory Flexibility Act to consider the effect of its regulations on small entities. In 

order to do this, the SEC needs to determine whether you meet the Small Business Administration’s definition of 

“small business” for purposes of entities that provide investment and related activities. Accordingly, answer “Yes” 

or “No,” as appropriate, to the questions below: 

 

A. Did the applicant have annual receipts of less than $7 million during its most recent fiscal year (or during 

the time the applicant has been in business, if it has not completed its first fiscal year in business)? 

Yes

No 

B. Is the applicant affiliated with any business or organization that had annual receipts of $7 million or more 

during its most recent fiscal year (or during the time it has been in business, if it has not completed its first 

fiscal year in business)? 

 Yes No

 
FORM MA 

SCHEDULE A 

Direct Owners and Executive Officers of the Applicant

 

1. Complete Schedule A only if submitting an initial application. Schedule A asks for information about the 

applicant’s direct owners and executive officers. Use Schedule C to amend this information. To determine 

direct ownership and executive officer status, see instruction 2 below. 

Separate subparts of Schedule A must be completed for: (1) direct owners that are business entities, and (2) 

direct owners and executive officers who are natural persons, as follows:

• Complete Schedule A-1: “Direct Owners of Applicant – Business Entities,” for owners that are 

organized as a business or other legal entity, such as a corporation, partnership, trust, or limited 

liability company. 

• Complete Schedule A-2: “Direct Owners and Executive Officers of Applicant – Natural 

Persons,” for owners who are individuals, including sole proprietors, and for executive officers. 

2. List in either Schedule A-1 or Schedule A-2 below, or both, as applicable, the full names of: 

 

(a) If applicant is organized as a corporation, each shareholder that is a direct owner of 5% or more of a 

class of the applicant’s voting securities, unless applicant is a public reporting company (a company subject 

to Sections 12 or 15(d) of the Exchange Act). Direct owners include any person that owns, beneficially 

owns, has the right to vote, or has the power to sell or direct the sale of, 5% or more of a class of the 

applicant’s voting securities. For purposes of this Schedule, a person beneficially owns any securities: (i) 

owned by his/her child, stepchild, grandchild, parent, stepparent, grandparent, spouse, sibling, mother-inlaw, father-in-law, son-in-law, daughter-in-law, brother-in-law, or sister-in-law, sharing the same 

residence; or (ii) that he/she has the right to acquire, within 60 days, through the exercise of any option, 

warrant, or right to purchase the security; 

 

(b) If the applicant is organized as a partnership, all general partners and each limited and special partner 

that has the right to receive upon dissolution, or has contributed, 5% or more of the applicant’s capital; 

(c) In the case of a trust, a person that directly owns 5% or more of a class of the applicant’s voting 

securities, or that has the right to receive upon dissolution, or has contributed, 5% or more of the 

applicant’s capital, the trust and each trustee; 

(d) If the applicant is organized as a limited liability company (“LLC”), (i) each member that has the right 

to receive upon dissolution, or has contributed, 5% or more of the applicant’s capital, and (ii) if managed 

by elected managers, all elected managers; and 

(e) Each Chief Executive Officer, Chief Financial Officer, Chief Operations Officer, Chief Legal Officer, 

Chief Compliance Officer, director and any other individuals with similar status or functions (applies in 

Schedule A-2 only). 

3. In the DE/FE column of Schedule A-1 below, enter “DE” if the owner is a domestic entity, or “FE” if the 

owner is an entity organized, incorporated or domiciled in a foreign country. 

 

4. Complete the Title or Status column by entering board/management titles; status as partner, trustee, sole 

proprietor, elected manager, shareholder, or member. For shareholders or members, indicate the class of 

securities owned (if more than one is issued). In the next column, indicate the date that the title or status was 

acquired.
 

5. Ownership codes are: 

NA - less than 5% 

A - 5% but less than 10% 

B - 10% but less than 25% 

C - 25% but less than 50%

D - 50% but less than 75% 

E - 75% or more 

 

6. (a) In the Control Person column, enter “Yes” in the first sub-column if the person has control as defined in 

the Glossary of Terms to Form MA, and enter “No” if the person does not have control. Note that under 

this definition, most executive officers and all 25% owners, general partners, elected managers, and trustees 

are control persons. 

(b) In the PR sub-column (Schedule A-1 only) enter “PR” if the owner is a public reporting company under 

Sections 12 or 15(d) of the Exchange Act. 

7. (a) For Schedule A-1, enter the organization CRD number. If not registered with the CRD, then enter the IRS 

Tax Number, Employer Identification Number (“EIN”), or Foreign Business Number. 

(b) For Schedule A-2, enter the individual CRD number. If not registered with the CRD, then enter 0000000. 

8. Does applicant have any indirect owners to be reported on Schedule B? 

Yes No

Schedule A-1: Direct Owners of Applicant – Business Entities 

BUSINESS ENTITY

FULL LEGAL NAME

DE/FE Title 

or 

Status

Date Title or

Status 

Acquired

Ownership 

Code

Control 

Person

Organization CRD No.

(If None: IRS Tax No., EIN, or 

Foreign Business No.)

MM YYYY Yes/ 

No

PR CRD

No.

IRS 

Tax 

No.

EIN

Foreign 

Bus. 

No.

Schedule A-2: Direct Owners and Executive Officers of Applicant – Natural Persons

NATURAL PERSON

FULL LEGAL NAME 

Enter all the letters of each name 

and not initials or other 

abbreviations. If no middle 

name, enter NMN on that line.

Title 

or 

Status

Date Title or 

Status 

Acquired

Ownership 

Code

Control 

Person

Individual CRD No.

(If none: enter 0000000) 

Last 

Name

First 

Name

Middle 

Name 

MM YYYY Yes/No CRD No.
FORM MA 

SCHEDULE B 

 

Indirect Owners of the Applicant

 

1. Complete Schedule B only if applicant is submitting an initial application. Schedule B asks for 

information about the applicant’s indirect owners. The applicant must first complete Schedule A, which asks 

for information about direct owners. For purposes of Schedule B, an “indirect owner” includes any owner of 

25% or more of any direct owner listed in Schedule A, and any owner of 25% or more of each such indirect 

owner going up the chain of ownership. Use Schedule C to amend the information in this schedule. To 

determine indirect ownership, see instructions 2 and 3 below. 

Separate subparts of Schedule B must be completed for: (1) indirect owners that are business entities, and (2) 

indirect owners who are natural persons, as follows: 

• Complete Schedule B-1: “Indirect Owners of Applicant – Business Entities,” for owners who are 

organized as business or other legal entities, such as a corporation, partnership, trust, or limited 

liability company. 

• Complete Schedule B-2: “Indirect Owners of Applicant – Natural Persons,” for individuals and 

sole proprietors.

2. With respect to each direct owner listed on Schedule A-1 (business entities), list in either Schedule B-1 or 

Schedule B-2 below, as applicable: 

(a) in the case of a direct owner listed on Schedule A-1 that is a corporation, each of its shareholders that 

beneficially owns, has the right to vote, or has the power to sell or direct the sale of, 25% or more of a class 

of a voting security of that corporation; 

For purposes of this Schedule, a person beneficially owns any securities: (i) owned by his/her child, stepchild, 

grandchild, parent, stepparent, grandparent, spouse, sibling, mother-in-law, father-in-law, son-in-law, daughter-in-law, 

brother-in-law, or sister-in-law, sharing the same residence; or (ii) that he/she has the right to acquire, within 60 days, 

through the exercise of any option, warrant, or right to purchase the security. 

 

(b) in the case of a direct owner listed on Schedule A-1 that is a partnership, all general partners and each 

limited and special partner that has the right to receive upon dissolution, or has contributed, 25% or more of 

the partnership’s capital; 

(c) in the case of a direct owner listed on Schedule A-1 that is a trust, the trust and each trustee; and 

(d) in the case of a direct owner listed on Schedule A-1 that is a limited liability company (“LLC”), (i) 

each member that has the right to receive upon dissolution, or has contributed, 25% or more of the LLC’s 

capital, and (ii) if managed by elected managers, each elected manager. 

 

3. Continue up the chain of indirect ownership listing all 25% shareholders at each level. Once a public 

reporting company (a company subject to Sections 12 or 15(d) of the Exchange Act) is reached, no further 

ownership information need be given. 

 

4. In the DE/FE column in Schedule B-1 below, enter “DE” if the indirect owner is a domestic entity, or “FE” if 

the owner is an entity organized, incorporated or domiciled in a foreign country. Complete the next column by 

indicating the entity in the chain of ownership in which this indirect owner has an interest. 

 

5. Complete the Status column by entering the indirect owner’s status as partner, trustee, elected manager, 

shareholder, or member. For shareholders or members, indicate the class of securities owned (if more than one 
is issued). 

6. Ownership codes are: 

C - 25% but less than 50% 

D - 50% but less than 75% 

E - 75% or more 

F - Other (general partner, trustee, or elected manager) 

7. (a) In the Control Person column, enter “Yes” in the first sub-column if the person has control as defined in 

the Glossary of Terms to Form MA, and enter “No” if the person does not have control. Note that under 

this definition, most executive officers and all 25% owners, general partners, elected managers, and trustees 

are control persons. 

(b) In the PR sub-column, for Schedule B-1 only, enter “PR” if the indirect owner is a public reporting 

company under Sections 12 or 15(d) of the Exchange Act. 

8. (a) For Schedule B-1, enter the organization CRD number. If not registered with the CRD, then enter the IRS 

Tax Number, Employer Identification Number (“EIN”), or Foreign Business Number. 

(b) For Schedule B-2, enter the individual CRD number. If not registered with the CRD, then enter 0000000. 

Schedule B-1: Indirect Owners of Applicant – Business Entities

BUSINESS ENTITY

FULL LEGAL NAME

DE/FE Entity 

In 

Which 

Interest 

Is 

Owned

Title 

or 

Status 

Date Title or 

Status 

Acquired

Ownership 

Code

Control 

Person

Organization CRD No.

(If None: IRS Tax No., EIN, 

or Foreign Business No.)

MM YYYY Yes/No PR CRD

No.

IRS 

Tax 

No.

EIN 

Foreign 

Bus.

No.

Schedule B-2: Indirect Owners of Applicant – Natural Persons

NATURAL PERSON

FULL LEGAL NAME

Enter all the letters of each 

name and not initials or other 

abbreviations. If no middle 

name, enter NMN on that line.

Entity

In 

Which 

Interest 

Is 

Owned

Status Date Title or 

Status 

Acquired

Ownership 

Code

Control 

Person

Individual CRD No.

(If none: enter 0000000)

Last 

Name

First 

Name

Middle 

Name 

MM YYYY Yes/No CRD No.
FORM MA 

SCHEDULE C 

 

Amendments to Schedules A and B 

 

1. Use Schedule C only to amend information requested on either Schedule A or Schedule B. Refer to 

instructions in Schedule A and Schedule B, which also apply for this Schedule C. 

2. In the Type of Amendment column, indicate “A” (addition), “D” (deletion), or “C” (change in information 

about the same person). 

 

3. Ownership codes are: 

NA - less than 5% 

A - 5% but less than 10% 

B - 10% but less than 25%

C - 25% but less than 50% 

D - 50% but less than 75% 

E - 75% or more 

F - Other (general partner, trustee, or elected member) 

4. List below all changes to Schedule A: 

Schedule A-1: Direct Owners of Applicant – Business Entities 

TYPE OF 

AMENDMENT

BUSINESS ENTITY

FULL LEGAL NAME

DE/ 

FE

Title 

or 

Status

Date Title 

or Status 

Acquired

Ownership 

Code

Control 

Person

Organization CRD No.

(If None: IRS Tax No., EIN, or 

Foreign Business No.)

MM YYYY Yes/ 

No

PR CRD

No.

IRS 

Tax 

No.

EIN Foreign 

Bus. No.

Schedule A-2: Direct Owners and Executive Officers of Applicant – Natural Persons

TYPE OF 

AMENDMENT

NATURAL PERSON

FULL LEGAL NAME

Enter all the letters of each 

name and not initials or 

other abbreviations. If no 

middle name, enter NMN 

on that line.

Title 

or 

Status

Date Title 

or Status 

Acquired

Ownership 

Code

Control 

Person

Individual CRD No.

(If None: enter 0000000) 

Last 

Name

First 

Name

Middle 

Name 

MM YYYY Yes/No CRD No.
5. List below all changes to Schedule B: 

Schedule B-1: Indirect Owners of Applicant – Business Entities

TYPE 

OF 

AMEDMENT

BUSINESS 

ENTITY

FULL LEGAL 

NAME

DE

/FE

Entity In 

Which 

Interest 

Is 

Owned

Status Date Title or 

Status 

Acquired

Ownership 

Code

Control 

Person

Organization CRD No.

(If None: IRS Tax No., EIN, or 

Foreign Business No.)

MM YYYY Yes/

No

PR

Schedule B-2: Indirect Owners of Applicant – Natural Persons

TYPE OF 

AMENDMENT

NATURAL PERSON

FULL LEGAL NAME

Enter all the letters of 

each name and not 

initials or other 

abbreviations. If no 

middle name, enter 

NMN on that line.

Entity

In 

Which 

Interest 

Is 

Owned

Status Date Title or 

Status 

Acquired

Ownership 

Code

Control 

Person

Individual CRD No.

(If None: enter 0000000)

Last 

Name

First 

Name

Middle 

Name 

MM YYYY Yes/No CRD No. 

 
FORM MA 

SCHEDULE D 

 

Certain items in Part I of Form MA require additional information on Schedule D. Use this Schedule D to report 

details for items listed below. Report only new information or changes/updates to previously submitted 

information. Do not repeat previously submitted information. 

 

This is an: INITIAL or AMENDED Schedule D or ANNUAL UPDATE

SECTION 1-B Other Names under which Municipal Advisor-Related Business is Conducted 

 

List the applicant’s other business names and the jurisdictions in which they are used. A separate Schedule D must 

be completed for each business name and the jurisdictions where that name is used.

 

Select only one: Add Delete Amend

Name __________________________________________ Jurisdictions: ______________________________ 

(List all jurisdictions.) 

SECTION 1-D Additional Registrations of the Applicant 

 

Indicate any additional registrations with federal or state regulators, and the relevant registration number. A 

separate Schedule D must be completed for each such registration. 

Name ____________________________________________ Registration No. ___________________________ 

SECTION 1-E Additional Offices at which the Applicant’s Municipal Advisor-Related Business is Conducted 

 

Provide the location of the largest five additional offices (in terms of numbers of employees) at which the 

applicant’s municipal advisor-related business is conducted other than applicant’s principal office and place of 

business. A separate Schedule D must be completed for each such office.

 

Select only one: Add Delete Amend

_______________________________________________________________________ 

(number and street)

_______________________ _________ ___________ ___________________ 

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

_________________________________ _____________________________ 

Telephone number at this location Fax number (if any) at this location 

(area code) (telephone number) (area code) (fax number)

For non-US telephone and fax numbers, include country code with area code and local number.

If this address is a private residence, check this box: 

A private residential address will not be included in publicly available versions of this registration form.

SECTION 1-F Additional Website Addresses 

 

List any additional website addresses of the applicant. A separate Schedule D must be completed for each such 

website address. 

 

Select only one: Add Delete Amend

Website Address: ________________________________________________ 
SECTION 1-I Location of Books and Records 

 

Complete the following information for each location at which the applicant keeps books and records, other than its 

principal office and place of business. A separate Schedule D must be completed for each location. 

 

Select only one: Add Delete Amend

Name of entity where books and records are kept: _______________________________ 

_______________________________________________________________________ 

(number and street)

_______________________ _________ ___________ ___________________ 

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

_________________________________ _____________________________ 

Telephone number at this location Fax number (if any) at this location 

(area code) (telephone number) (area code) (fax number)

For non-US telephone and fax numbers, include country code with area code and local number.

If this address is a private residence, check this box: 

A private residential address will not be included in publicly available versions of this registration form.

This is (select only one): one of applicant’s branch offices or affiliates 

a third-party unaffiliated recordkeeper

 other 

 

Briefly describe the books and records kept at the location(s) you checked. If you checked “other,” describe 

additionally all such location(s). 

__________________________________________________________________________________________ 

__________________________________________________________________________________________ 

__________________________________________________________________________________________ 

__________________________________________________________________________________________ 

SECTION 1-J Registration with Foreign Financial Regulatory Authorities 

 

List the full name, in English, of each foreign financial regulatory authority, provide the foreign registration 

number (if any), and list the full name, in English, of the country with which the applicant is registered. A separate 

Schedule D must be completed for each foreign financial regulatory authority with whom the applicant is 

registered. 

 

Select only one: Add Delete Amend

 

______________________________________________ _________________ ____________________ 

English Name of Foreign Financial Regulatory Authority Foreign Registration English Name of Country

No. (if any) 
SECTION 1-K Business Affiliates of the Applicant 

 

Provide the name of any domestic or foreign business affiliate of the applicant, and any federal, state, or foreign 

registration of such affiliate and the registration number. A separate Schedule D must be completed for each such 

affiliate. 

Name of Affiliate: _______________________________________________ 

1. Does the affiliate have an applicable federal, state, or foreign registration? 

Yes No 

2. If “Yes” to Section 1-K (1) above, provide the:

(a) Name of Agency Issuing Registration (in English): ___________________________________

(b) Registration No., if any: ________________________

(c) Provide the jurisdiction (check the appropriate box, and if a US state or other jurisdiction, or a foreign 

country, provide the name of the jurisdiction): 

US Federal

 US State or Other US Jurisdiction: _________________ 

 Foreign Country Name (in English): __________________________________

SECTION 3 Successions 

 

Complete the following information if succeeding to the business of a currently-registered municipal advisor. If the 

applicant succeeded more than one municipal advisory firm in the succession being reported on this Form MA, a 

separate Schedule D must be completed for each predecessor firm. See Instruction 1 of the Specific Instructions for 

Certain Items in Form MA included in the General Instructions. 

Name of Predecessor Municipal Advisory Firm: __________________________________________________ 

 

Municipal Advisor SEC File No.: _____________ 

Municipal Securities Dealer SEC File No.: _____________ 

Broker-Dealer SEC File No.: _____________ Organization CRD No.: 

__________ 

Investment Adviser 

 SEC-Registered SEC File No.: _________ _

Organization CRD No.: __________

 Exempt Reporting Adviser SEC File No.: __________ Organization CRD No.: 

__________ 

Investment Adviser Registration in a US State or Other US Jurisdiction: If predecessor municipal advisory firm 

is registered in a US state or other jurisdiction as an investment adviser, check the Registered in US State or 

Other US Jurisdiction box below and enter the organization CRD Number. In the table below, check the box for 

each US jurisdiction in which the applicant is so registered.

 Registered in US State or Other US Jurisdiction Organization CRD No. 

___________ 

 

Check 

All 

That 

Apply 

US

State or 

Jurisdiction Code

Check 

All 

That 

Apply 

US

State or 

Jurisdiction Code

Alabama AL Montana MT
Alaska AK Nebraska NE

Arizona AZ Nevada NV

Arkansas AR New Hampshire NH

California CA New Jersey NJ

Colorado CO New Mexico NM

Connecticut CT New York NY

Delaware DE North Carolina NC

District of Columbia DC North Dakota ND

Florida FL Ohio OH

Georgia GA Oklahoma OK

Guam GU Oregon OR

Hawaii HI Pennsylvania PA

Idaho ID Puerto Rico PR

Illinois IL Rhode Island RI

Indiana IN South Carolina SC

Iowa IA South Dakota SD

Kansas KS Tennessee TN

Kentucky KY Texas TX

Louisiana LA Utah UT

Maine ME Vermont VT

Maryland MD Virgin Islands VI

Massachusetts MA Virginia VA

Michigan MI Washington WA 

Minnesota MN West Virginia WV 

Mississippi MS Wisconsin WI 

Missouri MO

Government Securities Broker-Dealer 

SEC File No.: _______________ Bank Identifier: _______________ 

Other SEC Registration (Specify): __________________________________ 

SEC File No. (if any): ___________ EDGAR CIK (if any): __________

Another federal or state regulator (Specify): ___________________________

Registration No. (if any): ___________ 

SECTION 4-D Firms and Other Persons that Solicit Municipal Advisor Clients on the Applicant’s Behalf 

 

Provide the name, address, and phone number of any firm or other person that is not otherwise an associated 

person of the applicant that solicits municipal advisor clients on the applicant’s behalf. A separate Schedule D 

must be completed for each such firm or natural person. 

 

Name: ___________________________________________________________ 

_____________________ ________________________ 

EDGAR CIK No. (if any) Individual CRD No. (if any)

_______________________________________________________________________ 

(number and street)

_______________________ _________ ___________ ___________________ 

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

_________________________________ _____________________________ 

Telephone number at this location Fax number (if any) at this location 

(area code) (telephone number) (area code) (fax number)
For non-US telephone and fax numbers, include country code with area code and local number.

If this address is a private residence, check this box: 

A private residential address will not be included in publicly available versions of this registration form.

SECTION 4-E Employees That Also Do Business Independently on the Applicant’s Behalf as Affiliates of the 

Applicant 

Name of Employee: 

Enter all the letters of each name and initials or other abbreviations. If no middle name, enter NMN on that line. 

 _______________ _______________ _______________ 

Last Name First Name Middle Name

_____________________ _______________________ 

EDGAR CIK No. (if any) Individual CRD No. (if any)

_______________________________________________________________________ 

(number and street)

_______________________ _________ ___________ ___________________ 

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

_________________________________ _____________________________ 

Telephone number at this location Fax number (if any) at this location 

(area code) (telephone number) (area code) (fax number)

For non-US telephone and fax numbers, include country code with area code and local number.

If this address is a private residence, check this box: 

A private residential address will not be included in publicly available versions of this registration form.

SECTION 5-B Description of Primary Business (for businesses not listed in Part A of Item 5) 

 

If you checked Item 5-B.2., describe the applicant’s primary business (not the applicant’s municipal advisor-related

business): 

____________________________________________________________________________________________ 

____________________________________________________________________________________________ 

____________________________________________________________________________________________ 

____________________________________________________________________________________________ 

 

SECTION 6 Financial Industry and Other Activities of Associated Persons

 

The following information must be completed for each associated person in every category you checked in Item 6-

A. This section must be completed separately for each such associated person. 

 

Select only one: Add Delete Amend

Legal Name of Associated Person: ________________________________________________________________ 

Primary Business Name of Associated Person: 

_______________________________________________________ 

A. Associated person is a:

Check all that apply.

 

 (1) Broker-dealer, municipal securities dealer, or government securities broker or dealer

(2) Investment company (including mutual funds) 

 (3) Investment adviser (including financial planners) 
 (4) Swap dealer 

 (5) Security-based swap dealer 

 (6) Major swap participant 

 (7) Major security-based swap participant 

 (8) Commodity pool operator (whether registered or exempt from registration) 

 (9) Commodity trading advisor (whether registered or exempt from registration) 

 (10) Futures commission merchant 

 (11) Banking or thrift institution 

 (12) Trust company 

 (13) Accountant or accounting firm 

 (14) Attorney or law firm 

 (15) Insurance company or agency 

 (16) Pension consultant 

 (17) Real estate broker or dealer 

 (18) Sponsor or syndicator of limited partnerships 

 (19) Engineer or engineering firm 

 (20) Other municipal advisor 

B. Control Relationships and Foreign Registrations

(1) Control Relationships

(a) Does the applicant control or is it controlled by the associated person? 

Yes No 

(b) Are the applicant and the associated person under common control? 

Yes No 

 

(2) Foreign Financial Regulatory Authority Registration 

 

(a) Is the associated person registered with a foreign financial regulatory authority? Yes

No 

(b) If the answer to (2)(a) is “Yes,” list in English the name of each foreign financial regulatory authority, 

the associated person’s registration number with that authority (if any), and the country in which the 

authority has jurisdiction. 

______________________________________________ _____________ _______________________ 

English Name of Foreign Financial Regulatory Authority Registration English Name of Country

Number (if any)

______________________________________________ _____________ _______________________ 

English Name of Foreign Financial Regulatory Authority Registration English Name of Country

Number (if any)

SECTION 8 Control Persons (on a basis other than 25% ownership or executive officer status)

Section 8-A. A separate Schedule D must be completed for each control person not named in Item 1-A or 

Schedules A, B, or C that directly or indirectly controls the applicant’s management or policies. 

 

Select only one: Add Delete Amend 

The control person is a (select only one): Firm or organization. You must complete Section 8-A (1).

 Natural person. You must complete Section 8-A (2). 

(1) If the control person is a firm or organization: 

 Name_________________________________________________________________ 

 

Municipal Advisor 
Form MA-T Registration SEC File No.: _______________ 

Effective Date: ______________ Termination Date: _____________

 mm/dd/yyyy mm/dd/yyyy 

Form MA Registration SEC File No.: _______________ 

Effective Date: ______________ Termination Date: _____________ 

 mm/dd/yyyy mm/dd/yyyy 

Municipal Securities Dealer SEC File No.: ______________ 

Effective Date: _________________ Termination Date: _________________

 mm/dd/yyyy mm/dd/yyyy 

 

 Broker-Dealer SEC File No.: ___________ Organization CRD No.: _____________

Effective Date: _________________ Termination Date: _________________ 

 mm/dd/yyyy mm/dd/yyyy

 Investment Adviser 

SEC-Registered SEC File No.: ________ Organization CRD No.: ________ 

Effective Date: ____________ Termination Date: ____________ 

 mm/dd/yyyy mm/dd/yyyy 

Exempt Reporting Adviser SEC File No.: ________ Organization CRD No.: _______

Effective Date: __________ Termination Date: _________________ 

 mm/dd/yyyy mm/dd/yyyy 

Investment Adviser Registration in a US State or Other US Jurisdiction: If control person is registered 

in a US state or other jurisdiction as an investment adviser, check the Registered in US State or Other 

US Jurisdiction box below, and enter the organization CRD Number and other information requested. 

In the table below, check the box for each US state or jurisdiction in which the control person is so 

registered.

Registered in US State or Other US Jurisdiction Organization CRD No. 

___________ Effective Date: _____________ Termination Date: 

_________________ 

 mm/dd/yyyy mm/dd/yyyy 

Check 

All 

That 

Apply 

US

State or 

Jurisdiction Code

Check 

All 

That 

Apply 

US

State or 

Jurisdiction Code

Alabama AL Montana MT

Alaska AK Nebraska NE

Arizona AZ Nevada NV

Arkansas AR New Hampshire NH

California CA New Jersey NJ

Colorado CO New Mexico NM

Connecticut CT New York NY

Delaware DE North Carolina NC

District of Columbia DC North Dakota ND

Florida FL Ohio OH

Georgia GA Oklahoma OK

Guam GU Oregon OR

Hawaii HI Pennsylvania PA
Idaho ID Puerto Rico PR

Illinois IL Rhode Island RI

Indiana IN South Carolina SC

Iowa IA South Dakota SD

Kansas KS Tennessee TN

Kentucky KY Texas TX

Louisiana LA Utah UT

Maine ME Vermont VT

Maryland MD Virgin Islands VI

Massachusetts MA Virginia VA

Michigan MI Washington WA 

Minnesota MN West Virginia WV 

Mississippi MS Wisconsin WI 

Missouri MO

 Government Securities Broker-Dealer SEC File No.: ___________ Bank Identifier: ___________ 

Effective Date: _________________ Termination Date: _________________ 

 mm/dd/yyyy mm/dd/yyyy

 

 Other SEC Registration (Specify) ____________________________ 

SEC File No. (if any): _______________ EDGAR CIK (if any): ______________ 

Effective Date: _________________ Termination Date: _________________ 

 mm/dd/yyyy mm/dd/yyyy 

 

 Another Federal or State Regulator (Specify) _________________________________ 

Registration No. (if any): _________________ 

Effective Date: _________________ Termination Date: _________________ 

 mm/dd/yyyy mm/dd/yyyy 

Business Address

_______________________________________________________________________ 

(number and street)

_______________________ _________ ___________ ___________________

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

_________________________________ _____________________________ 

Telephone number at this location Fax number (if any) at this location 

(area code) (telephone number) (area code) (fax number)

For non-US telephone and fax numbers, include country code with area code and local number.

If this address is a private residence, check this box: 

A private residential address will not be included in publicly available versions of this registration form.

Briefly describe the nature of the control: 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

(2) If control person is a natural person: 

 

Enter all the letters of each name and not initials or other abbreviations. If no middle name, enter NMN on that 

line.

 _______________ _______________ _______________ 
Last Name First Name Middle Name

_____________________ 

EDGAR CIK No. (if any)

_______________________ _______________________ _______________________ 

Individual CRD No. (if any) Effective Date Termination Date

_______________________________________________________________________ 

(number and street)

_______________________ _________ ___________ ___________________ 

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

_________________________________ _____________________________ 

Telephone number at this location Fax number (if any) at this location 

(area code) (telephone number) (area code) (fax number)

For non-US telephone and fax numbers, include country code with area code and local number.

If this address is a private residence, check this box: 

A private residential address will not be included in publicly available versions of this registration form.

Briefly describe the nature of the control: 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

Section 8-B. If any person named in Schedules A, B, or C or in Section 8-A of this Schedule D is a public 

reporting company under Section 12 or 15(d) of the Securities Exchange Act of 1934, provide the 

information below. A separate Section 8-B of Schedule D must be completed for each public reporting 

company. 

1. Full legal name of the public reporting company: _________________________________________

2. The public reporting company’s EDGAR CIK number: ________________ 

3. The Schedules where the public reporting company was reported: 

Check all that apply.

Schedule A

Schedule B 

 Schedule C, Section 4 

 Schedule C, Section 5 

 Schedule D, Section 8-A 

 

Schedule D: MISCELLANEOUS 

 

The space below may be used to explain a response to an Item or to provide any other information. 

_____________________________________________________________________________________________

_____________________________________________________________________________________________ 

_____________________________________________________________________________________________ 

_____________________________________________________________________________________________

____________________________________________________________________________________________

_____________________________________________________________________________________________ 

_____________________________________________________________________________________________ 

_____________________________________________________________________________________________
____________________________________________________________________________________________

_____________________________________________________________________________________________ 
FORM MA 

PART II:

DISCLOSURE REPORTING PAGES (DRPs)

CRIMINAL ACTION DISCLOSURE REPORTING PAGE (MA)

CRIMINAL ACTION DRP – PART 1

This Disclosure Reporting Page (DRP MA) is an INITIAL OR AMENDED response used to report 

details for affirmative response(s) to Items 9-A or 9-B of Form MA. 

Check item(s) in Form MA for which this DRP is providing details: 

 9-A(1) 9-A(2) 9-B(1) 9-B(2) 

How to Report an Event or Proceeding on a Criminal Action DRP: Use a separate DRP for each event or 

proceeding. The same event or proceeding may be reported for more than one person or entity using one DRP. 

One event may result in more than one affirmative answer to Items 9-A(1), 9-A(2), 9-B(1), and/or 9-B(2). Use 

this DRP to report all charges, including multiple counts of the same charge, arising out of the same event and filed 

in one criminal action. Separate criminal actions arising out of the same event, and unrelated criminal actions, must 

be reported on separate DRPs. 

Requirement to Provide Court Documents: Applicable court documents (i.e., criminal complaint, information or 

indictment as well as judgment of conviction or sentencing documents) must be attached to, and filed electronically 

with, this DRP (if not previously submitted). 

Check all that apply, except where noted: 

A. The person(s) or entity(ies) concerning whom this DRP is being filed is (are) the:

 

Select only one. 

 Applicant (the municipal advisory firm) 

Applicant and one or more of the applicant’s associated person(s) 

One or more of applicant’s associated person(s) 

 

1. Applicant

 

(a) Is this DRP an amendment that seeks to remove a previously filed DRP concerning the applicant from 

the record? Yes No 

(b) If “Yes,” the reason the DRP should be removed is:

 

 The applicant is registered or has submitted an application for registration that is currently pending 

and the event or proceeding previously reported was resolved in the applicant’s favor. 

 The event or proceeding occurred more than ten years ago.

 The DRP was filed in error. Explain the circumstances: 

_______________________________________________________________________ 

_______________________________________________________________________ 

 
2. Associated Person(s)

(a) Does this DRP concern one or more associated persons? Yes No 

 

(i) If “Yes,” indicate the total number of such associated person(s): ___ 

(b) Identify each such associated person by checking below either the box for firm or for natural person, as 

appropriate, and provide the requested information: 

Firm 

Full legal name of the associated person:

______________________________________________________ 

The associated person is: 

 registered with the SEC SEC Registration No. ____________ 

 not registered with the SEC

CRD No., if any: ____________________ 

Is this DRP an amendment that seeks to remove a previously filed DRP concerning this associated 

person? Yes No 

If “Yes,” the reason the DRP should be removed is:

 

The associated person(s) is no longer associated with the advisor.

The event or proceeding was resolved in the associated person’s favor. 

The event or proceeding occurred more than ten years ago. 

 The DRP was filed in error. Explain the circumstances: 

 

_______________________________________________________________________ 

_______________________________________________________________________ 

Natural Person 

 

Full name of the associated person:

Enter all the letters of each name and not initials or other abbreviations. 

If no middle name, enter NMN on that line. 

_______________ _______________ _______________ _________ 

Last Name First Name Middle Name Suffix 

The associated person is: 

 registered with the SEC SEC Registration No. ____________

 not registered with the SEC

CRD No., if any: ____________________ 

Provide the information for each additional firm below:

_____________________________________________
Is this DRP an amendment that seeks to remove a previously filed DRP concerning this associated 

person? Yes No 

If “Yes,” the reason the DRP should be removed is:

 

The associated person(s) is no longer associated with the advisor.

The event or proceeding was resolved in the associated person’s favor. 

The event or proceeding occurred more than ten years ago. 

 The DRP was filed in error. Explain the circumstances: 

_______________________________________________________________________ 

_______________________________________________________________________ 

B. DRP filed elsewhere for this event: Is an accurate and up-to-date DRP containing the information regarding 

the applicant or associated person required by this DRP already on file (a) in the IARD or CRD system (with a 

Form ADV, BD, or U4), or (b) in the SEC’s EDGAR system (with a Form MA or Form MA-I)?

Yes

If the answer is “Yes,” provide the applicable information indicated below that identifies where the DRP 

may be found. 

 1. Form ADV, BD, or U4 Filing: For a DRP filed on the IARD or CRD system with one of these 

forms, provide the following information: 

 

Name on Registration: _________________________________________________ 

CRD No.: __________________ Disclosure Occurrence No.: ___________________ 

2. Form MA Filing: For a DRP filed on EDGAR with a Form MA, provide the following 

information:

 

Name on Registration: _________________________________________________ 

MA Registration Number: __________________ 

Date of filing that contains the DRP (MM/DD/YYYY): _________________ 

Accession number of the filing: ________________________

 

 3. Form MA-I Filing: For a DRP filed on EDGAR with a Form MA-I, provide the following 

information:

 

Name of Individual: _________________________________________________

MA-I File Number: __________________ 

Date of filing that contains the DRP (MM/DD/YYYY): _________________ 

Accession number of the filing: ________________________

No 

If the answer is “Yes,” no other information on this DRP (other than set forth above) must be provided. 

If the answer is “No,” complete Part 2 below. 

NOTE: The completion of all or any part of this form does not relieve the municipal advisor or 

associated person of its obligation to update its IARD or CRD records 

Provide the information for each additional natural person below:

_______________________________________________________

CRIMINAL ACTION DRP – PART 2

 

1. Firm or Organization 

A. Were charge(s) brought against a firm or organization over which the applicant or an associated 

person exercise(s)(d) control? Yes No 

B. If “Yes,” provide the following information: 

(1) Enter the firm or organization name: __________________________________________

(2) Was the firm or organization engaged in a municipal advisor-related or investment-related business? 

Yes No 

(3) What was the relationship of the applicant or the associated person with the firm or organization? 

(Include any position or title with the firm or organization.) 

_______________________________________________________________________________ 

2. Court Where Formal Charge(s) Were Brought: (File a separate Criminal Action DRP for charges brought 

in separate courts and/or separate cases in the same court. If brought in a foreign jurisdiction, provide all 

the information below in English.) 

Federal Court

Military Court 

State Court 

 Foreign Country Court 

 International Court 

 Other : ___________________________ 

A. Name of the Court: ___________________________________________________________________ 

B. Location of the Court

 

Street Address: ______________________________________________________________

City or County: ______________________ State/Country: ________________________ 

Postal Code: __________________

 C. Docket/Case Number and Case Name:______________________________

3. Event Disclosure Detail (Use this for both organizational and individual charges.) 

A. Date First Charged (MM/DD/YYYY): ___________________ Exact Explanation 

If not exact, provide explanation:

___________________________________________________________________________________ 

___________________________________________________________________________________ 

B. Details of Event: Report all charges separately. For each charge, provide all of the following information. 

(1) First Charge

(a) List the charge/charge description: 

________________________________________________________________________________ 

___________________________________________________________________________________

_____________________________________________________________________________ 
___________________________________________________________________________________

___________________________________________________________________________________

__________________________________________________________________________ 

(b) Number of counts: ___ 

 

(c) Check the applicable box: Felony Misdemeanor 

(d) Plea for this charge: 

_____________________________________________________________________________ 

(e) (i) Is the charge municipal advisor-related? Yes No 

(ii) If “Yes,” what is the product type? 

_________________________________________________________________________ 

 

(f) (i) Is the charge investment-related? Yes No 

(ii) If “Yes,” what is the product type? 

_________________________________________________________________________ 

 

(g) (i) Amended Charge: Indicate if the original charge was amended or reduced: 

Yes No 

(ii) If “Yes,” provide the date the charge was amended or reduced (MM/DD/YYYY):

___________________

C. Felony Charge(s): Did any of the charge(s) within the event involve a felony? Yes No 

 

4. Current Status of the Event: Pending On Appeal Final 

 

5. Event Status Date (Complete unless status is pending) (MM/DD/YYYY): ___________________

Exact Explanation 

If not exact, provide explanation: 

_______________________________________________________________________________________

_______________________________________________________________________________________ 

6. On Appeal – Judicial Review: If Item 4 On Appeal is checked, to whom was the criminal action 

appealed? (If brought in a foreign jurisdiction, provide all the information below in English.) 

Federal Court

Military Court 

State Court 

 Foreign Country Court 

 International Court 

 Other (specify): ___________________________ 

Provide the name and location of the court, docket/case number, and case name: 

______________________________________________________________________________________ 

Date appeal filed (MM/DD/YYYY): ___________________

Report the information for each additional charge below:

___________________________________________________

___________________________________________________
7.

Disposition Disclosure Detail (For each charge provide the following information):

(a) First Charge

(1) Disposition of the Charge 

(Check all that apply to this charge.) 

 Acquitted Found not guilty Pretrial diversion/intervention

 Amended Pled guilty Reduced

 Convicted 

 Deferred Adjudication

 Dismissed

 Pled nolo contendere

 Pled not guilty

 Other (specify) ____________ 

 Appealed 

 Affirmed

 Vacated & Returned For Further Action 

 Vacated / Final 

 Other (specify) ______________________

Explanation: If more than one disposition is checked, and/or Other is checked, or the above otherwise 

does not adequately summarize the disposition of the charge, provide an explanation. 

_______________________________________________________________________________ 

_______________________________________________________________________________ 

_______________________________________________________________________________ 

_______________________________________________________________________________ 

(2) Date (MM/DD/YYYY): _____________ 

 

(3) Sentence/Penalty: Is a sentence or other penalty ordered? Yes No 

 

If “Yes,” list each type (e.g., prison, jail, probation, community service, counseling, education, other - 

specify): 

______________________________________________________________________________ 

_______________________________________________________________________________ 

_______________________________________________________________________________ 

(4) Is there an incarceration in connection with this sentence? Yes No 

If “Yes,” provide the following details: 

(i) Duration (length of the sentence): Days ___ Months ___ Years ___

(ii) Start Date of Penalty (MM/DD/YYYY): _________________ Not determined. 

 

(iii) End Date of Penalty (MM/DD/YYYY): _________________ Not determined. 

 

(iv) Is the sentence to be served concurrently with any other sentence? Yes No

If yes, indicate the end date of the concurrent sentence (MM/DD/YYYY): 

_______________________ 

For Item 7: If Item 4 Final or On Appeal is checked, complete Item 7.

For Pending Actions, skip to Item 8.
 

(v) Explanation (Optional): 

__________________________________________________________________________ 

__________________________________________________________________________ 

(5) Monetary Penalty/Fine: 

(i) Was a monetary penalty/fine imposed? Yes No 

If “Yes,” provide the following details in (ii) and (iii) below:

(ii) Total Penalty/Fine Amount: $___________ 

(iii)Was any portion suspended/reduced? 

Yes If “Yes,” how much? $___________ 

No 

 

(iv) Final Amount: $___________ 

 

(v) Was the final amount paid in full?

 Yes If “Yes,” date paid in full (MM/DD/YYYY):____________

No 

If “No,” indicate the amount unpaid: $___________

And explain the circumstances:

_____________________________________________________________________________ 

_____________________________________________________________________________

 

8. Summary of Circumstances: Use this space to provide a brief summary of the circumstances leading to the 

action, allegation(s), finding(s) and disposition(s), if any. Include any relevant information on the current 

action status, and on any terms, conditions, and dates not already provided above, and any other relevant 

information. The information must fit within the space provided. 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________

Report the disposition(s) of each additional charge below:

____________________________________________________

_________________________________________________________
REGULATORY ACTION DISCLOSURE REPORTING PAGE (MA)

 

REGULATORY ACTION DRP – PART 1 

This Disclosure Reporting Page (DRP MA) is an INITIAL OR AMENDED response used to report 

details for affirmative responses to Items 9-C, 9-D, 9-E, 9-F or 9-G of Form MA. 

Check item(s) being responded to: 

 9-C(1) 9-C(2) 9-C(3) 9-C(4) 9-C(5)

 9-D(1) 9-D(2) 9-D(3) 9-D(4) 9-D(5)

 9-E(1) 9-E(2) 9-E(3) 9-E(4)

 9-F 9-G 

How to Report an Event or Proceeding on a Regulatory Action DRP: Use a separate DRP for each event or 

proceeding. The same event or proceeding may be reported for more than one person or entity using one DRP. 

One event may result in more than one affirmative answer to Items 9-C, 9-D, 9-E, 9-F, and/or 9-G. If an event 

gives rise to actions by more than one regulator, provide details for each action on a separate DRP.

Check all that apply, except where noted: 

 

A. The person(s) or entity(ies) for whom this DRP is being filed is (are) the:

 Select only one. 

 Applicant (the municipal advisory firm) 

 Applicant and one or more of the applicant’s associated person(s) 

One or more of applicant’s associated person(s) 

 

1. Applicant

 

(a) Is this DRP an amendment filed for the applicant that seeks to remove a previously filed DRP 

concerning the applicant from the record? Yes No 

 

(b) If “Yes,” the reason the DRP should be removed is:

 

 The applicant is registered or applying for registration and the event or proceeding was resolved in 

the applicant’s favor. 

 The DRP was filed in error. Explain the circumstances: 

_______________________________________________________________________ 

_______________________________________________________________________ 

2. Associated Person(s)

(a) Is this DRP being filed for one or more associated persons? Yes No 

 

(i) If “Yes,” indicate the total number of such associated person(s): ___ 

(b) Identify each such associated firm and/or natural person in the space below: 

Firm 

Full name of the associated person:

 ______________________________________________________ 

The associated person is: 

 
 registered with the SEC SEC Registration No. ____________ 

 not registered with the SEC

CRD No., if any: ____________________ 

Is this DRP an amendment that seeks to remove a previously filed DRP concerning this associated 

person? 

Yes No 

If “Yes,” the reason the DRP should be removed is:

 

The associated person(s) is no longer associated with the advisor.

The event or proceeding was resolved in the associated person’s favor. 

 The DRP was filed in error. Explain the circumstances: 

 

_______________________________________________________________________ 

_______________________________________________________________________ 

Natural Person 

 

Full name of the associated person:

Enter all the letters of each name and not initials or other abbreviations.

If no middle name, enter NMN on that line. 

_______________ _______________ _______________ _________ 

Last Name First Name Middle Name Suffix 

The associated person is: 

 registered with the SEC SEC Registration No. ____________

 not registered with the SEC

CRD No., if any: ____________________ 

Is this DRP an amendment that seeks to remove a previously filed DRP concerning this associated 

person? 

Yes No 

If “Yes,” the reason the DRP should be removed is:

 

The associated person(s) is no longer associated with the advisor.

The event or proceeding was resolved in the associated person’s favor. 

 The DRP was filed in error. Explain the circumstances: 

_______________________________________________________________________ 

_______________________________________________________________________ 

Provide the ral person below:

Provide the information for each additional firm below:

___________________________________________

Provide the information for each additional natural person below:

__________________________________________________________
B. DRP filed elsewhere for this event: Is an accurate and up-to-date DRP containing the information regarding 

the applicant or associated person required by this DRP already on file (a) in the IARD or CRD system (with a 

Form ADV, BD, or U4), or (b) in the SEC’s EDGAR system (with a Form MA or Form MA-I)?

Yes

If the answer is “Yes,” provide the applicable information indicated below that identifies where the DRP 

may be found. 

1. Form ADV, BD, or U4 Filing: For a DRP filed on the IARD or CRD system with one of these 

forms, provide the following information: 

 

Name on Registration: _________________________________________________ 

CRD No.: __________________ Disclosure Occurrence No.: ___________________ 

2. Form MA Filing: For a DRP filed on EDGAR with a Form MA, provide the following 

information:

 

Name on Registration: _________________________________________________ 

MA Registration Number: __________________ 

Date of filing that contains the DRP (MM/DD/YYYY): _________________ 

Accession number of the filing: ________________________

 

 3. Form MA-I Filing: For a DRP filed on EDGAR with a Form MA-I, provide the following 

information:

 

Name of Individual: _________________________________________________

MA-I File Number: __________________ 

Date of filing that contains the DRP (MM/DD/YYYY): _________________ 

Accession number of the filing: ________________________

No 

If the answer is “Yes,” no other information on this DRP (other than set forth above) must be provided. 

If the answer is “No,” complete Part 2 below. 

NOTE: The completion of all or any part of this form does not relieve the municipal advisor or 

associated person of its obligation to update its IARD or CRD records. 
REGULATORY ACTION DRP – PART 2 

 

1. Regulatory Action was initiated by: 

A. Select the Appropriate Item. 

Select only one box below. A separate Regulatory Action DRP is required for each such regulator or other 

authority. 

 

SEC State Foreign Financial Regulatory Authority

CFTC SRO Other: _________________________

Federal Banking Agency

National Credit Union Administration

 Other Federal Authority

 

B. Full name of the individual regulator (if not fully identified in Item 1-A) or other authority that 

initiated the action. For a foreign financial regulatory authority, please provide the full name in English. 

___________________________________________________________________________________ 

 

2. Sanction(s) Sought: 

Check all that apply.

 

Bar (Permanent) Disgorgement Restitution

Bar (Temporary / Time Limited) Expulsion Requalification 

Cease and Desist Injunction Revocation

 Censure Prohibition Suspension

Civil and Administrative Penalty(ies)/Fine(s) Reprimand Undertaking 

Denial Rescission

 

Other Sanction(s) Sought (list each such additional sanction): 

 _______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

3. Date Initiated (MM/DD/YYYY): ____________________ Exact Explanation 

 

If not exact, provide explanation: 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

4. Regulatory Action was brought in (if brought in a foreign jurisdiction, provide all the information below in 

English): 

A. Name of the Administrative Proceeding, Commission/Agency Hearing, or other regulatory proceeding

or forum: ________________________________________________________ 

B. Location of the Proceeding / Hearing: 

Street Address: ______________________________________________________________

City or County: ______________________ State/Country: _______________________ 

Postal Code: __________________

C. Docket/Case Number: __________________
5. A. Principal Product Type (check appropriate item):

 

 No Product 

 Annuity – Charitable Direct Investment – DPP & LP Interest Oil & Gas

 Annuity – Fixed Equipment Leasing Options 

 Annuity – Variable Equity Listed (Common & Preferred Stock) Penny Stock 

 Banking Product Equity OTC Prime Bank Instrument 

(other than CD) Futures – Commodity Promissory Note 

CD Futures – Financial Real Estate Security

 Commodity Option Index Option Security Futures 

Debt – Asset Backed Insurance Security-based Swap

Debt – Corporate Investment Contract Swap

Debt – Government Money Market Fund Unit Investment Trust

Debt – Municipal Mutual Fund Viatical Settlement

Derivative

Other Principal Product Type (specify): 

___________________________________________________________________________________ 

 

B. Other Product Types? Yes No If “Yes,” describe each additional product type: 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

6. Allegations: Describe the allegations related to this regulatory action. (The response must fit within the space 

provided.) 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

7. Current Status: Pending On Appeal Final 

8. Pending: If you checked Item 7 Pending, provide the following information. 

A. Date Served: The date that notice or other process was served (MM/DD/YYYY): _______________

Exact Explanation 

If not exact, provide explanation: 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

 

B. Limitation or Restrictions: Are there any limitations or restrictions currently in effect? 

Yes No 

If the answer is “Yes,” provide details:

___________________________________________________________________________________ 

___________________________________________________________________________________ 

 

9. On Appeal – Administrative or Judicial Review of the Regulatory Action: If you appealed, provide the 

following information. 
A. Name of Regulator or Court Action Appealed To: Provide the name of the US regulator (i.e., the SEC, 

an SRO, other), federal court, state court or state regulator, or a foreign or international court or regulator 

to whom you appealed. If brought in a foreign jurisdiction, provide all the information below in English. 

 ___________________________________________________________________________ 

B. Location of the Regulator or Judicial Court to Whom You Appealed:

 

Street Address: ______________________________________________________________

City or County: ______________________ State/Country: _______________________ 

Postal Code: __________________

 C. Docket/Case Name: __________________________________________________________

D. Docket/Case Number:______________________________

E. Date Appeal filed (MM/DD/YYYY): ______________ Exact Explanation 

If not exact, provide explanation: 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

F. Appeal Details (including status): 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

G. Limitation or Restrictions: Are there any limitations or restrictions currently in effect while on appeal? 

Yes No 

If the answer is “Yes,” provide details:

___________________________________________________________________________________

___________________________________________________________________________________ 

 

10.

A. Resolution: How was the action resolved? (Check all the applicable boxes that reflect the 

most recent resolution of the action by a regulator or a court, whether or not any part of the resolution is 

on appeal. If any part of the resolution is on appeal, identify in Item 10-B which part is currently on 

appeal.) 

 Acceptance, Waiver & Consent (AWC) Dismissed Stipulation and Consent 

 Consent Judgment Rendered Withdrawn 

 Decision Order Other (requires explanation)

 Decision & Order of Offer of Settlement Settled 

 Appealed 

 Affirmed

 Vacated Nunc Pro Tunc / ab initio

 Vacated & Returned For Further Action 

 Vacated / Final 

 Other (requires explanation)

If you checked Item 7 Final or On Appeal, complete Items 10 through 13.

For Pending Actions, skip to Item 13.
B. Explanation: If more than one box in Item 10-A is checked, or Other is checked, or Item 10-A otherwise 

does not adequately summarize the type of resolution, provide an explanation. For example, if you 

appealed all or part of a resolution by the regulator or court, indicate what is being appealed. 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

C. Order: If Order is checked above in Item 10-A, does the order constitute a final order based on 

violations of any laws or regulations that prohibit fraudulent, or deceptive conduct? Yes

No

11. Resolution Date (MM/DD/YYYY):____________________ Exact Explanation 

(For a resolution that is being appealed in part, the date to be provided should be the date on which the 

regulator (reviewing a decision by an SRO or an Administrative Law Judge) or a court provided its resolution.) 

If not exact, provide explanation: 

_________________________________________________________________________________________ 

_________________________________________________________________________________________ 

_________________________________________________________________________________________ 

_________________________________________________________________________________________ 

_________________________________________________________________________________________ 

_________________________________________________________________________________________ 

12. Resolution Detail 

 

A. Sanction(s): Were any Sanctions Ordered? Yes 

 No, none were ordered. 

B. If “Yes,” check each individual sanction below that was ordered: 

 

Bar (Permanent) Disgorgement* Restitution* 

Bar (Temporary / Time Limited) Expulsion Requalification 

Cease and Desist Injunction Revocation

 Censure Prohibition Suspension 

Civil and Administrative Penalty(ies)/Fine(s)* Reprimand Undertaking 

Denial Rescission

* Monetary Sanction(s): Were one or more sanctions ordered that require a monetary payment? 

Yes No 

 If “Yes,” enter the total amount ordered: $_____________

Other Sanction(s) Ordered (list each such additional sanction): 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

C. Sanction Detail (Provide the details of the following specific sanctions, if checked above in Item 12-

B.) 
(1) Barred, Enjoined, or Suspended: If you checked one or more of these sanctions in Item 12-B. above, 

check the applicable box(es) below and provide the corresponding information. 

(a) Barred 

 

(i) Duration (length of time):

 Permanent (not limited by length of time). 

Temporary / Time Limited. Specify the: Days ___ Months ___ Years ___

 

(ii) Start Date (MM/DD/YYYY): ______________ Exact Explanation 

If not exact, provide explanation: 

_______________________________________________________________________________

_______________________________________________________________________________ 

(iii) End Date (MM/DD/YYYY): ______________ Exact Explanation 

If not exact, provide explanation: 

_______________________________________________________________________________

_______________________________________________________________________________ 

(iv) Description: Provide remaining details and the registration capacities affected (General 

Securities Principal, Financial Operations Principal, etc.). If none, enter “None”: 

 _________________________________________________________________________ 

 _________________________________________________________________________ 

 _________________________________________________________________________ 

 _________________________________________________________________________ 

 _________________________________________________________________________ 

 _________________________________________________________________________ 

 

(b) Enjoined 

(i) Duration (length of time): 

 

 Permanent (not limited by length of time). 

Temporary / Time Limited. Specify the: Days ___ Months ___ Years ___

 

(ii) Start Date (MM/DD/YYYY): ______________ Exact Explanation 

 

If not exact, provide explanation: 

_______________________________________________________________________________

_______________________________________________________________________________ 

(iii) End Date (MM/DD/YYYY): ______________ Exact Explanation 

If not exact, provide explanation: 

_______________________________________________________________________________

_______________________________________________________________________________ 

If the applicant or an associated person received in the above action one or more bars from 

registration capacities, associations, and/or other activities; and the terms specify different 

time periods; report the additional details below:

________________________________________________________________________
(iv) Description: Provide remaining details and the registration capacities affected (General 

Securities Principal, Financial Operations Principal, etc.). If none, enter “None”: 

 _________________________________________________________________________ 

 _________________________________________________________________________ 

 _________________________________________________________________________ 

 _________________________________________________________________________ 

 _________________________________________________________________________ 

 _________________________________________________________________________ 

(c) Suspended 

(i) Duration (length of time): 

 

 Permanent (not limited by length of time). 

Temporary / Time Limited. Specify the: Days ___ Months ___ Years ___

 

(ii) Start Date (MM/DD/YYYY): ______________ Exact Explanation 

 

If not exact, provide explanation: 

_______________________________________________________________________________

_______________________________________________________________________________ 

(iii) End Date (MM/DD/YYYY): ______________ Exact Explanation 

If not exact, provide explanation: 

_______________________________________________________________________________

_______________________________________________________________________________ 

 

(iv) Description: Provide remaining details and the registration capacities affected (General 

Securities Principal, Financial Operations Principal, etc.). If none, enter “None”: 

_________________________________________________________________________

 _________________________________________________________________________ 

 _________________________________________________________________________ 

(2) Requalification: Was requalification by examination, retraining, or other process a condition of a 

sanction? Yes No 

If “Yes,” provide: 

If the applicant or an associated person received in the above action one or more injunctions 

from registration capacities, associations, and/or other activities; and the terms specify different 

time periods; report the additional details below:

_________________________________________________________________

If the applicant or an associated person received in the above action one or more suspensions 

from registration capacities, associations, and/or other activities; and the terms specify different 

time periods; report the additional details below: 
(a) Length of time given to requalify, retrain, or complete other process: 

 

 No time period is specified. 

Time period is specified: Days ___ Months ___ Years ___

(b) Type of examination, retraining, or other process required: 

_____________________________________________________________________________ 

_____________________________________________________________________________ 

(c) Was the condition satisfied? Yes No 

(1) If “Yes,” provide the date (MM/DD/YYYY): ______________ 

(2) If “No,” explain the circumstances: 

_________________________________________________________________________ 

_________________________________________________________________________ 

(3) Monetary Sanction(s): If you indicated in Item 12-B above that one or more monetary sanctions were 

ordered, provide the following information. 

 

(a) Total Amount Ordered: $___________ 

(b) Portion levied against: 

Applicant 

(i) Amount Ordered: $___________ 

(ii) Was any portion waived? 

Yes 

No 

If “Yes,” how much? $___________ 

(iii)Final Amount: $___________ 

 

(iv) Was final amount paid in full?

 

Yes 

No 

If “Yes,” date paid in full (MM/DD/YYYY):____________

If “No,” explain the circumstances:

______________________________________________________________________ 

______________________________________________________________________ 

 Associated Person

If the applicant or an associated person received in the above action one or more 

requalifications in connection with registration capacities, associations, and/or other 

activities; and the terms specify different time periods; report the additional details below:

_____________________________________________________________________
(i) Amount Ordered: $___________ 

(ii) Was any portion waived? 

 Yes ________ 

No 

If “Yes,” how much? $___________

(iii)Final Amount: $___________ 

 

(iv) Was final amount paid in full?

Yes 

No 

If “Yes,” date paid in full (MM/DD/YYYY):____________

If “No,” explain the circumstances:

______________________________________________________________________ 

______________________________________________________________________ 

13. Summary of Circumstances: Use this space to provide a brief summary of the circumstances leading to the 

action, allegation(s), finding(s) and disposition(s), if any. Include any relevant information on the current 

action status, and on any terms, conditions, and dates not already provided above, and any other relevant 

information. The information must fit within the space provided. 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

CIVIL JUDICIAL ACTION DISCLOSURE REPORTING PAGE (MA)

CIVIL JUDICIAL ACTION DRP – PART 1 

This Disclosure Reporting Page (DRP MA) is an INITIAL OR AMENDED response used to report 

details for affirmative responses to Item 9-H. of Form MA.

Check item(s) being responded to: 9-H(1)(a) 9-H(1)(b) 9-H(1)(c) 9-H(2) 

How to Report an Event or Proceeding on a Civil Judicial Action DRP: Use a separate DRP for each event or 

proceeding. The same event or proceeding may be reported for more than one person or entity using one DRP. 

One event may result in more than one affirmative answer to Item 9-H. Separate cases arising out of the same 

event, and unrelated civil judicial actions, must be reported on separate DRPs; if they are later consolidated into a 

single civil judicial action, the consolidated action can be reported on one DRP. 

Check all that apply, except where noted: 

 

A. The person(s) or entity(ies) for whom this DRP is being filed is (are) the:

 Select only one. 

Provide the information for each additional associated person below:

___________________________________________________

___________________________________________________
 Applicant (the municipal advisory firm) 

 Applicant and one or more of the applicant’s associated person(s) 

One or more of applicant’s associated person(s) 

 

1. Applicant

(a) Is this DRP an amendment filed for the applicant that seeks to remove a previously filed DRP 

concerning the applicant from the record? Yes No 

 

(b) If “Yes,” the reason the DRP should be removed is:

 

 The applicant is registered or applying for registration and the event or proceeding was resolved in 

the applicant’s favor. 

 The DRP was filed in error. Explain the circumstances: 

_______________________________________________________________________ 

_______________________________________________________________________ 

2. Associated Person(s)

(a) Is this DRP being filed for one or more associated persons? Yes No 

(i) If “Yes,” indicate the total number of such associated person(s): ___ 

(b) Identify each such associated firm and/or natural person in the space below: 

 

Firm 

Full name of the associated person:

 ______________________________________________________ 
The associated person is: 

 

 registered with the SEC SEC Registration No. ____________ 

 not registered with the SEC

CRD No., if any: ____________________ 

Is this DRP an amendment that seeks to remove a previously filed DRP concerning this associated 

person? 

Yes No 

If “Yes,” the reason the DRP should be removed is:

 

The associated person(s) is no longer associated with the advisor.

The event or proceeding was resolved in the associated person’s favor. 

 The DRP was filed in error. Explain the circumstances: 

 _______________________________________________________________________ 

_______________________________________________________________________ 

Natural Person 

 

Full name of the associated person:

Enter all the letters of each name and not initials or other abbreviations. 

If no middle name, enter NMN on that line. 

_______________ _______________ _______________ _________ 

Last Name First Name Middle Name Suffix 

The associated person is: 

 registered with the SEC SEC Registration No. ____________

 not registered with the SEC

CRD No., if any: ____________________ 

Is this DRP an amendment that seeks to remove a previously filed DRP concerning this associated 

person? 

Yes No 

If “Yes,” the reason the DRP should be removed is:

The associated person(s) is no longer associated with the advisor.

The event or proceeding was resolved in the associated person’s favor. 

 The DRP was filed in error. Explain the circumstances: 

 _______________________________________________________________________ 

_______________________________________________________________________ 

Provide the information for each additional firm below:

_______________________________________________

Provide the information for each additional natural person below:

________________________________________________________
B. DRP filed elsewhere for this event: Is an accurate and up-to-date DRP containing the information regarding 

the applicant or associated person required by this DRP already on file (a) in the IARD or CRD system (with a 

Form ADV, BD, or U4), or (b) in the SEC’s EDGAR system (with a Form MA or Form MA-I)?

 Yes

If the answer is “Yes,” provide the applicable information indicated below that identifies where the DRP 

may be found. 

1. Form ADV, BD, or U4 Filing: For a DRP filed on the IARD or CRD system with one of these 

forms, provide the following information: 

 

Name on Registration: _________________________________________________ 

CRD No.: __________________ Disclosure Occurrence No.: ___________________ 

2. Form MA Filing: For a DRP filed on EDGAR with a Form MA, provide the following 

information:

 

Name on Registration: _________________________________________________ 

MA Registration Number: __________________ 

Date of filing that contains the DRP (MM/DD/YYYY): _________________ 

Accession number of the filing: ________________________

 

 3. Form MA-I Filing: For a DRP filed on EDGAR with a Form MA-I, provide the following 

information:

 

Name of Individual: _________________________________________________

MA-I File Number: __________________ 

Date of filing that contains the DRP (MM/DD/YYYY): _________________ 

Accession number of the filing: ________________________

No 

If the answer is “Yes,” no other information on this DRP (other than set forth above) must be provided. 

If the answer is “No,” complete Part 2 below. 

NOTE: The completion of all or any part of this form does not relieve the municipal advisor or 

associated person of its obligation to update its IARD or CRD records. 
CIVIL JUDICIAL ACTION DRP – PART 2 

1. Court Action was initiated by: 

 A. Select the Appropriate Item(s). 

Check all that apply. 

 

SEC State Foreign Financial Regulatory Authority

CFTC SRO Municipal Advisory Firm

 Other Federal Authority Commodities Exchange Private Plaintiff

 

Other: _______________________________ 

B. Plaintiff(s): Enter the full name(s) of the plaintiff(s), unless only SEC and/or CFTC is/are checked 

above. For a foreign financial regulatory authority, please provide the full name in English. 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

Were all plaintiffs fully identified in the space provided? Yes No 

2. Defendant(s): 

A. Enter the full name(s) of the defendant(s). For foreign defendant(s), please provide the full name(s) in 

English: 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

B. Are you a named defendant? Yes No If “No,” describe how this action involves you: 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

 ___________________________________________________________________________________ 

 

3. Sanction(s) or Relief Sought (check appropriate items): 

Bar (Permanent) Exemption Rescission

Bar (Temporary / Time Limited) Expulsion Restitution

Cease and Desist Injunction Restraining Order 

 Censure Money Damage(s) Requalification 

Civil /Administrative Penalty(ies)/Fine(s) (Private/Civil Complaint) Revocation

Denial Prohibition Suspension 

Disgorgement Reprimand Undertaking 

Other Sanction(s) or Relief Sought: 
_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

4. A. Filing Date of Court Action (MM/DD/YYYY): ____________________

Exact Explanation 

If not exact, provide explanation: 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

B. Date Notice/Process was served (MM/DD/YYYY): _________________

Exact Explanation 

If not exact, provide explanation: 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

5. Formal Action was brought in (If brought in a foreign jurisdiction, provide all the information below in 

English): 

 

Check the applicable box:

Federal Court Military Court State Court Foreign Court International Court 

 Other : ___________________________ 

A. Name of the Court:______________________________________________________________ 

B. Location of the Court

 

Street Address: _______________________________________________________________

City or County: ______________________ State/Country: ________________________ 

Postal Code: __________________

C. Docket/Case Number and Case Name:______________________________

6. A. Principal Product Type (check appropriate item): 

 

 No Product 

 Annuity – Charitable Direct Investment – DPP & LP Interest Oil & Gas

 Annuity – Fixed Equipment Leasing Options 

 Annuity – Variable Equity Listed (Common & Preferred Stock) Penny Stock 

 Banking Product Equity OTC Prime Bank Instrument 

(other than CD) Futures – Commodity Promissory Note 

CD Futures – Financial Real Estate Security

 Commodity Option Index Option Security Futures 

Debt – Asset Backed Insurance Security-based Swap

Debt – Corporate Investment Contract Swap

Debt – Government Money Market Fund Unit Investment Trust 
Debt – Municipal Mutual Fund Viatical Settlement

Derivative

Other Principal Product Type (specify): 

___________________________________________________________________________________ 

B. Other Product Types? Yes No If “Yes,” describe each additional product type: 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

7. Allegations: Describe the allegations related to this civil action. (The response must fit within the space 

provided.) 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

8. Current Status: Pending On Appeal Final 

9. Pending: If you checked Item 8 Pending, provide the following information. 

 

A. Date Served: The date that notice or other process was served (MM/DD/YYYY): _______________

Exact Explanation 

If not exact, provide explanation: 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

 

B. Limitation or Restrictions: Are there any limitations or restrictions currently in effect? 

Yes No 

If the answer is “Yes,” provide details:

___________________________________________________________________________________ 

___________________________________________________________________________________ 

 

10. On Appeal – Judicial Review: If you appealed, provide the following information. 

(If brought in a foreign jurisdiction, provide all the information below in English): 

A. Action Appealed to: (Provide the name of the federal, state, foreign, or international court to whom you 

appealed.) __________________________________________________________________________ 

B. Location of the Court: 

Street Address: ____________________________________________________________ 

City or County: ______________________ State/Country: ______________________ 

Postal Code: __________________ 

C. Docket/Case Name: _______________ 

D. Docket/Case Number: _______________ 

E. Date Appeal filed (MM/DD/YYYY): ______________ Exact Explanation 

 

If not exact, provide explanation: 
___________________________________________________________________________________ 

___________________________________________________________________________________ 

F. Appeal Details (including status): 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

G. Limitation or Restrictions: Are there any limitations or restrictions currently in effect while on appeal? 

Yes No 

If the answer is “Yes,” provide details:

___________________________________________________________________________________ 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

11. A.

Resolution: How was the action resolved? Check all the applicable boxes that reflect the most recent

 resolution of the action by a court, whether or not any part of the resolution is on appeal. If any part of 

the resolution is on appeal, identify in Item 11-B which part is currently on appeal. 

 

 Consent Judgment Rendered Stipulation and Consent

 Decision Opinion Withdrawn

 Decision & Order of Offer of Settlement Order

 Dismissed Settled

 Other: _______________________

 

 Appealed 

 Affirmed

 Vacated Nunc Pro Tunc / ab initio

 Vacated & Returned For Further Action 

 Vacated / Final 

 Other: _______________________

B. Explanation: If more than one box in Item 11-A is checked or Item 11-A otherwise does not adequately 

summarize the type of resolution, provide an explanation. For example, if you appealed all or part of a 

resolution by the regulator or court, indicate what is being appealed. 

___________________________________________________________________________________ 

___________________________________________________________________________________ 

C. Order: If Order is checked above in Item 11-A, does the order constitute a final order based on violations 

of any laws or regulations that prohibit fraudulent, or deceptive conduct? Yes No

12. Resolution Date (MM/DD/YYYY):____________________ Exact Explanation 

If you checked Item 8 Final or On Appeal, complete Items 11 through 14. 

For Pending Actions, skip to Item 14. 
(For a resolution that is being appealed in part, the date to be provided should be the date on which the 

regulator or court provided its resolution.) 

If not exact, provide explanation: 

____________________________________________________________________________________ 

____________________________________________________________________________________ 

 

13. Resolution Detail

 

A. Sanction(s): Were any Sanctions Ordered or Relief Granted? 

Yes 

 No, none were ordered, or granted. 

B. If “Yes,” check each individual sanction ordered and/or relief granted below: 

 

Bar (Permanent) Exemption Rescission

Bar (Temporary / Time Limited) Expulsion Restitution*

Cease and Desist Injunction Restraining Order 

 Censure Money Damage(s) Requalification 

Civil /Administrative Penalty(ies)/Fine(s)* (Private/Civil Complaint)* Revocation

Denial Prohibition Suspension 

Disgorgement* Reprimand Undertaking 

* Monetary Sanction(s): Were one or more sanctions ordered that require a monetary payment? 

Yes No 

If “Yes,” enter the total amount ordered: $_____________

 

Other Sanctions Ordered or Relief Granted (list each such additional sanction or relief):

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

 

C. Sanction Detail (Provide the details of the following specific sanctions, if checked above in Item 13-B.)

(1) Barred, Enjoined, or Suspended: If you checked one or more of these sanctions in Item 13-B. above, 

check the applicable box(es) below and provide the corresponding information. 

(a) Barred 

 

(i) Duration (length of time): 

 

 Permanent (not limited by length of time). 

Temporary / Time Limited. Specify the: Days ___ Months ___ Years ___

 

(ii) Start Date (MM/DD/YYYY): ______________ Exact Explanation 

 

If not exact, provide explanation:

________________________________________________________________________ 

________________________________________________________________________ 

(iii) End Date (MM/DD/YYYY): ______________ Exact Explanation 

If not exact, provide explanation:
_____________________________________________________________________ 

_____________________________________________________________________ 

 

(iv) Description: Provide remaining details and the registration capacities affected (General 

Securities Principal, Financial Operations Principal, etc.). If none, enter “None”: 

 _________________________________________________________________________ 

 _________________________________________________________________________ 

 _________________________________________________________________________ 

 _________________________________________________________________________ 

 _________________________________________________________________________ 

 _________________________________________________________________________ 

 

(b) Enjoined 

(i) Duration (length of time): 

 

 Permanent (not limited by length of time). 

Temporary / Time Limited. Specify the: Days ___ Months ___ Years ___

 

(ii) Start Date (MM/DD/YYYY): ______________ Exact Explanation 

 

If not exact, provide explanation:

_____________________________________________________________________ 

_____________________________________________________________________ 

(iii) End Date (MM/DD/YYYY): ______________ Exact Explanation 

If not exact, provide explanation:

_____________________________________________________________________

_____________________________________________________________________ 

 

(iv) Description: Provide remaining details and the registration capacities affected (General 

Securities Principal, Financial Operations Principal, etc.). If none, enter “None”: 

 _________________________________________________________________________ 

 _________________________________________________________________________ 

 _________________________________________________________________________ 

 _________________________________________________________________________ 

(c) Suspended 

If the applicant or an associated person received in the above action one or more injunctions 

from registration capacities, associations, and/or other activities; and the terms specify different

time periods; report the additional details below:

________________________________________________________________________

If the applicant or an associated person received in the above action one or more bars from 

registration capacities, associations, and/or other activities; and the terms specify different 

time periods; report the additional details below:

_____________________________________________________________________
(i) Duration (length of time): 

 

 Permanent (not limited by length of time). 

Temporary / Time Limited. Specify the: Days ___ Months ___ Years ___

 

(ii) Start Date (MM/DD/YYYY): ______________ Exact Explanation 

If not exact, provide explanation:

_____________________________________________________________________

_____________________________________________________________________ 

(iii) End Date (MM/DD/YYYY): ______________ Exact Explanation 

If not exact, provide explanation:

_____________________________________________________________________ 

_____________________________________________________________________ 

(iv) Description: Provide remaining details and the registration capacities affected (General 

Securities Principal, Financial Operations Principal, etc.). If none, enter “None”: 

_________________________________________________________________________ 

 _________________________________________________________________________ 

 _________________________________________________________________________ 

 _________________________________________________________________________ 

(2) Requalification: Was requalification by examination, retraining, or other process a condition of a 

sanction? Yes No 

If “Yes,” provide: 

(a) Length of time given to requalify, retrain, or complete other process: 

 

 No time period is specified. 

Time period is specified: Days ___ Months ___ Years ___

(b) Type of examination, retraining, or other process required: 

_____________________________________________________________________________ 

_____________________________________________________________________________ 

(c) Was the condition satisfied? Yes No 

(1) If “Yes,” provide the date (MM/DD/YYYY): ______________ 

 

(2) If “No,” explain the circumstances: 

_________________________________________________________________________ 

_________________________________________________________________________ 

If the applicant or an associated person received in the above action one or more suspensions 

from registration capacities, associations, and/or other activities; and the terms specify different 

time periods; report the additional details below:

_______________________________________________________________________________

If the applicant or an associated person received in the above action one or more 

requalifications in connection with registration capacities, associations, and/or other activities;

and the terms specify different time periods; report the additional details below:
(3) Monetary Sanction(s): If you indicated in Item 13-B above that one or more monetary sanctions were 

ordered, provide the following information. 

(a) Total Amount Ordered: $___________ 

(b) Portion levied against: 

 Applicant 

(i) Amount Ordered: $___________ 

(ii) Was any portion waived? 

Yes 

No 

If “Yes,” how much? $___________ 

(iii) Final Amount: $___________ 

 

(iv) Was final amount paid in full?

 Yes ______

No 

If “Yes,” date paid in full (MM/DD/YYYY):___________

If “No,” explain the circumstances:

______________________________________________________________________ 

______________________________________________________________________ 

 Associated Person

(i) Amount Ordered: $___________ 

(ii) Was any portion waived? 

Yes 

No 

If “Yes,” how much? $___________ 

(iii) Final Amount: $___________ 

 

(iv) Was final amount paid in full?

Yes 

No 

If “Yes,” date paid in full (MM/DD/YYYY):____________

If “No,” explain the circumstances:

______________________________________________________________________ 

______________________________________________________________________ 

Provide the information for each additional associated person below:

___________________________________________________________

___________________________________________________________
 

14. Summary of Circumstances: Use this space to provide a brief summary of the circumstances leading to the 

action, allegation(s), finding(s) and disposition(s), if any. Include any relevant information on the current 

action status, and on any terms, conditions, and dates not already provided above, and any other relevant 

information. The information must fit within the space provided. 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

 
Form MA

APPLICATION FOR MUNICIPAL ADVISOR REGISTRATION

 

DOMESTIC MUNICIPAL ADVISOR EXECUTION 

You must complete the following execution page to Form MA. This execution page must be signed and attached to 

your initial application for SEC registration and all amendments to registration.

Appointment of Agent for Service of Process

By signing this Form MA, you, the undersigned advisor, irrevocably appoint the Secretary of State or other legally 

designated officer, of the state in which you maintain your principal office and place of business, as your agents to 

receive service, and agree that such persons may be served any process, pleadings, subpoenas, or other papers in (a) 

any investigation or administrative proceeding conducted by the Commission that relates to the applicant or about 

which the applicant may have information; and (b) any civil suit or action brought against the applicant or to which 

the applicant has been joined as defendant or respondent, in any appropriate court in any place subject to the 

jurisdiction of any state or of the United States of America or of any of its territories or possessions or of the District 

of Columbia, where the investigation, proceeding or cause of action arises out of or relates to or concerns municipal 

advisory activities of the municipal advisor. The applicant stipulates and agrees that any such civil suit or action or 

administrative proceeding may be commenced by the service of process upon, and that service of an administrative 

subpoena shall be effected by service upon the above-named Agent for Service of Process, and that service as 

aforesaid shall be taken and held in all courts and administrative tribunals to be valid and binding as if personal 

service thereof had been made.

Signature

I, the undersigned, sign this Form MA on behalf of, and with the authority of, the municipal advisor. The municipal 

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, including exhibits and any other information submitted, are true 

and correct, and that I am signing this Form MA as a free and voluntary act. 

I certify that the advisor’s books and records will be preserved and available for inspection as required by law. 

Finally, I authorize any person having custody or possession of these books and records to make them available to 

federal regulatory representatives.

Signature: __________________ Date: ____________________ 

Printed Name: _______________ Advisor CRD Number (if any): _______________ 

Title: _________________ 
Form MA

APPLICATION FOR MUNICIPAL ADVISOR REGISTRATION

NON-RESIDENT MUNICIPAL ADVISOR EXECUTION 

Instructions: If you are a non-resident, you must complete these steps:

1. Execution Page: You must complete the following non-resident execution page to Form MA. This execution 

page must be signed and attached to your initial application for SEC registration and all amendments to 

registration.

2. Opinion of Counsel: You must also attach to Form MA an Opinion of Counsel. See General Instructions. 

3. Form MA-NR: You must also attach to Form MA one or more executed Form MA-NR(s) for the non-resident 

municipal advisor applicant, and, if any, the non-resident general partner(s) and/or non-resident managing 

agents. See General Instructions for Form MA-NR. 

 

Non-Resident Municipal Advisor Undertaking Regarding Books and Records 

By signing this Form MA, you agree to provide, at your own expense, to the U.S. Securities and Exchange 

Commission at its principal office in Washington D.C., at any Regional or District Office of the Commission, or at 

any one of its offices in the United States, as specified by the Commission, correct, current, and complete copies of 

any or all records that you are required to maintain by law. This undertaking shall be binding upon you, your heirs, 

successors and assigns, and any person subject to your written irrevocable consents or powers of attorney or any of 

your general partners and managing agents.

Signature 

I, the undersigned, sign this Form MA on behalf of, and with the authority of, the non-resident municipal advisor. 

The municipal 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, including exhibits and any other information submitted, 

are true and correct, and that I am signing this Form MA as a free and voluntary act. 

I certify that the municipal advisor’s books and records will be preserved and available for inspection as required by 

law. Finally, I authorize any person having custody or possession of these books and records to make them 

available to federal regulatory representatives. Further, attached to this Form MA as an exhibit is an opinion of 

counsel that the municipal advisor can, as a matter of law, provide the Commission with access to the books and 

records of such municipal advisor, as required by law, and that the municipal advisor can, as a matter of law, submit 

to inspection and examination by the Commission. Finally, attached to this Form MA is one or more executed Form 

MA-NR(s) for the non-resident municipal advisor applicant, and, if any, the non-resident general partner(s) and/or 

non-resident managing agents. 

Signature: __________________ Date: ____________________ 

Printed Name: ________________ Advisor CRD Number (if any): _______________ 

Title: _________________