Form MA Execution Form MA Execution Page

Form MA
APPLICATION FOR MUNICIPAL ADVISOR REGISTRATION
DOMESTIC MUNICIPAL ADVISOR EXECUTION PAGE
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 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: ____________________________

Title:

______________________

Advisor CRD Number: _____________________

DOMESTIC MUNICIPAL ADVISOR EXECUTION PAGE 2 OF 2

Self-Certification
I, the undersigned, sign this self-certification on behalf of and with the authority of the municipal advisor.
The municipal advisor and I both certify that the municipal advisor and every natural person associated
with it has met, or within any applicable required timeframes will meet, such standards of training,
experience, and competence, and such other qualifications, including testing, for a municipal advisor and
natural persons associated with it, required by the Commission, the MSRB or any other relevant selfregulatory organization.
The municipal advisor and I certify that the municipal advisor has conducted an initial or annual review, as
applicable, of the municipal advisor’s business and has reasonably determined that the municipal advisor:
1) can carry out the activities described in the items that are checked in Item 4.K (Applicant’s Business
Relating to Municipal Securities) of this form; 2) can comply with all applicable regulatory obligations; and
3) has met such regulatory obligations during the last year (or such shorter period if this is an initial
application for registration). For these purposes, such applicable regulatory obligations are obligations
under the federal securities laws and rules promulgated thereunder and applicable rules promulgated by the
MSRB, or any other relevant self-regulatory organization. The municipal advisor has documented this
review process and will maintain all documents relating to such review in accordance with rule 15Ba17(a)(8) under the Exchange Act.

Signature:

____________________________

Date:

______________________

Printed Name: ____________________________

Title:

______________________

Advisor CRD Number: _____________________

Form MA
APPLICATION FOR MUNICIPAL ADVISOR REGISTRATION
NON-RESIDENT MUNICIPAL ADVISOR EXECUTION
You must complete the following execution page to Form MA. You must also complete Form MA-NR.
This execution page must be signed and attached to your initial application for SEC registration and all
amendments to registration.

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 as an exhibit to this Form MA
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 onsite inspection and examination by the Commission.

Signature:

____________________________

Date:

______________________

Printed Name: ____________________________

Title:

______________________

Advisor CRD Number: _____________________

NON-RESIDENT MUNICIPAL ADVISOR EXECUTION

PAGE 2

Self-Certification
I, the undersigned, sign this self-certification on behalf of and with the authority of the municipal advisor.
The municipal advisor and I both certify that the municipal advisor and every natural person associated
with it has met, or within any applicable required timeframes will meet, such standards of training,
experience, and competence, and such other qualifications, including testing, for a municipal advisor and
natural persons associated with it, required by the Commission, the MSRB or any other relevant selfregulatory organization.
The municipal advisor and I certify that the municipal advisor has conducted an initial or annual review, as
applicable, of the municipal advisor’s business and has reasonably determined that the municipal advisor:
1) can carry out the activities described in the items that are checked in Item 4.K (Applicant’s Business
Relating to Municipal Securities) of this form; 2) can comply with all applicable regulatory obligations; and
3) has met such regulatory obligations during the last year (or such shorter period if this is an initial
application for registration). For these purposes, such applicable regulatory obligations are obligations
under the federal securities laws and rules promulgated thereunder and applicable rules promulgated by the
MSRB, or any other relevant self-regulatory organization. The municipal advisor has documented this
review process and will maintain all documents relating to such review in accordance with rule 15Ba17(a)(8) under the Exchange Act.

Signature:

____________________________

Date:

______________________

Printed Name: ____________________________

Title:

______________________

Advisor CRD Number: _____________________