Form MA Form MA Form MA

FORM MA
APPLICATION FOR MUNICIPAL ADVISOR REGISTRATION
ANNUAL UPDATE OF MUNICIPAL ADVISOR REGISTRATION
AMENDMENT OF A PRIOR APPLICATION FOR REGISTRATION
PART 1
This form must be completed by municipal advisors that are organized entities, including sole proprietors (referred
to herein as “municipal advisory firms”). Natural persons applying for registration as a municipal advisor, including
sole proprietors, must complete Form MA-I.
WARNING:

Complete this form truthfully. False statements or omissions may result in denial of
application, revocation of registration, 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. All italicized terms are defined or
described in the Glossary to this Form.

Check the appropriate box:
This is an:

 Initial application to register as a municipal advisor with the SEC.
 Annual update of municipal advisor’s Form MA, for fiscal year ended _________, or, if a sole proprietor,
for calendar year ____.
If no changes are made in this annual update to information provided in the municipal advisor’s most
recent Form MA, check here: 
 Amendment (other than annual update) to any part of the municipal advisor’s most recent Form MA.

Item 1

Identifying Information

A. Full legal name of the firm. (If the applicant is a sole proprietor, provide last, first, and middle names.)
___________________________________________________________
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. Name under which municipal advisor-related business is primarily conducted, if different from Item 1-A.
_____________________________________________________________________________
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.
 __________________________________________________
List on Section 1-B of Schedule D any additional names under which municipal advisor-related business is
conducted.
C. IRS employer identification number. If the applicant is a sole proprietor and has no employer identification
number, provide the applicant’s social security number.
___________________________________________________________
D. Registrations

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Was the applicant previously registered on Form MA-T as a municipal advisor?
 Yes
File No. _________
 No
Is the applicant registered as or with any of the following?
Check all that apply. An applicant firm that does not have a CRD number, or other specified number, should
enter nothing in the space provided. Such applicant should NOT provide the CRD number, or other specified
number, of any of its officers, employees, or affiliates.






Municipal Advisor
SEC File No.: _______________
Municipal Securities Dealer SEC File No.: ______________
Broker-Dealer
SEC File No.: _______________
Investment Adviser
 SEC-Registered
SEC File No.: ___________
 State Registered
CRD No. _______________
 Government Securities Broker-Dealer SEC File No.: _______________
 Other SEC Registration (Specify) ______________________
 Another federal or state regulator (Specify) ______________________

CRD No.: _______________
CRD No.: ______________
Bank Identifier ___________
SEC File No.: ______
Registration No.: __________

If more space is needed, list any additional registrations in Section 1-D of Schedule D.
E. Principal Office and Place of Business
Do not use a P.O. Box.
Address:

____________________________________________________________________
(number and street)

____________________________________________________________________
(city)

(state/country)

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

(zip+4/postal code)



List on Section 1-E of Schedule D any office(s) at which municipal advisor-related business is
conducted other than applicant’s principal office and place of business listed above.
Telephone number at this location: ___________________________________________
(area code)
(telephone number)
Fax number (if any) at this location: ____________________________________________
(area code)
(fax number)
Mailing address:
Complete this item only if mailing address is different from principal office and place of business address
in Item 1-E:

____________________________________________________________________
(number and street)

____________________________________________________________________
(city)

(state/country)

2

(zip+4/postal code)

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

Does the applicant have one or more websites?



Yes 

No 

If “yes,” list all 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:
___________________________________________________________________________
(name)
____________________________________________________________________________
(other title(s), if any)
________________________________ ____
____________________________________
(area code) (telephone number)
(area code) (fax number)

____________________________________________________________________
(number and street)

____________________________________________________________________
(city)

(state/country)

(zip+4/postal code)

_________________@________________________________
(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:
___________________________________________________________________________
(name)
____________________________________________________________________________
(title)
________________________________ ____
____________________________________
(area code) (telephone number)
(area code) (fax number)

____________________________________________________________________
(number and street)

____________________________________________________________________
(city)

(state/country)

(zip+4/postal code)

___________________@______________________________
(E-mail address of contact person)
I.

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 
If "yes,” complete Section 1-I of Schedule D.

J.

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 

If "yes," complete Section 1-J of Schedule D.
K. Is the applicant affiliated with any other business entities?

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Yes 

No 

If "yes," provide the names of these 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 an annual update or amendment, and the applicant’s form of organization has changed, 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: ___________________
C. The state in the U.S. or the jurisdiction outside the U.S. under which the 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.
____________________________
D. Date of organization: ___________________
E. Is the applicant a public reporting company under Sections 12 or 15(d) of the Securities Exchange Act of
1934?

 Yes

 No

If “yes”, provide applicant’s CIK number: ____________________
(A CIK, or Central Index Key number, is assigned by the SEC to every public reporting company.)

Item 3 Successions
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 General Instructions to this Form.

 Yes
Date of Succession:

____________________
(mm/dd/yyyy)

 No
If “yes,” complete Section 3 of Schedule D.

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Information About Applicant’s Business

Item 4

Note: Instruction 2 of the General Instructions to this Form 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. Approximate number of employees of applicant. Include full- and part-time employees, but do not include
clerical workers: _____________
B. Approximately how many of these employees engage in municipal advisory activities? (Include employees
who perform other functions in addition to engaging in municipal advisory activities.) _____________
C. Approximately how many of the employees who are included in the response to part B are registered
representatives of a broker-dealer? _______________
Approximately how many are registered representatives of an investment adviser? _______________
D. 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 the number entered includes firms, please list the names of these firms on Section 4D of Schedule D.
E. Does the applicant have any employees that also do business independently on the applicant’s behalf as
affiliates of the applicant?
 Yes  No
If yes, list the names of these employees on Section 4E of Schedule D.

Clients
F.

Approximately how many clients did the applicant serve in the context of its municipal advisory activities
during its most-recently completed fiscal year? ___________
The applicant has the following types of clients:
(Check all that apply.)






(1)
(2)
(3)
(4)
(5)

Municipal entities
Non-profit organizations (e.g., 501(c)(3) organizations) who are obligated persons
Corporations or other businesses not listed above who are obligated persons
Other: ___________________________
Not applicable - applicant engages only in solicitation; does not serve clients in the context of its
municipal advisory activities.

G. 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 them in the context of its municipal advisory activities, these clients should be counted
in the response to this Part G even if counted in Part F.) ___________
The applicant solicits the following types of persons:
(Check all that apply.)

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(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)

Public pension funds
529 Plans
Local government investment pools
State government investment pools
Hospitals
Colleges
Other: ___________________________
Not applicable – applicant only serves clients; does not engage in solicitation in the context of its
municipal advisory activities.

Compensation Arrangements
H. 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.)







I.

Hourly charges
Fixed fees (not contingent on the issuance of municipal securities)
Contingent fees
Subscription fees (for a newsletter or other publications)
Other (specify): __________________________________________________
Not applicable – applicant engages only in solicitation; does not serve clients in the context of its
municipal advisory activities.

Applicant is compensated for its solicitation activities by:
(Check all that apply.)







J.

(1)
(2)
(3)
(4)
(5)
(6)

(1)
(2)
(3)
(4)
(5)
(6)

Hourly charges
Fixed fees (not contingent on the success of solicitations)
Contingent fees
Subscription fees (for a newsletter or other publications)
Other (specify): __________________________________________________
Not applicable; applicant only serves clients; does not engage in solicitation as part of its
municipal advisory activities.

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
K. 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)

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 (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:
(Check all that apply.)
 (1) Broker-dealer, municipal securities dealer or government securities broker or dealer
 (2) Registered representative of a broker-dealer
 (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 or security-based swap dealer
 (9) Trust company
 (10) Real estate broker, dealer, or agent
 (11) Insurance company, broker, or agent
 (12) Banking or thrift institution (including a separately identifiable department or division of a bank)
 (13) Investment adviser (including financial planners)
 (14) Lawyer or law firm (Jurisdiction(s) where licensed: ___________________________)
 (15) Accountant or accounting firm (Jurisdiction(s) where licensed: ___________________________)
 (16) Engineering firm
 (17) Other financial product advisor (specify): _____________________________________
B. 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
If yes, is this other business applicant’s primary business?

 Yes

Also, if "yes", describe this other business on Section 5-B of Schedule D.

7

 No

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Item 6

Financial Industry Affiliations of Associated Persons

“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 solely clerical or
administrative.
Applicant has one or more associated persons that is a:
(Check all that apply.)





















(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
(16)
(17)
(18)
(19)
(20)

Broker-dealer, municipal securities dealer, or government securities broker or dealer
Investment company (including mutual funds)
Investment adviser (including financial planners)
Swap dealer
Security-based swap dealer
Major swap participant
Major security-based swap participant
Commodity pool operator (whether registered or exempt from registration)
Commodity trading advisor (whether registered or exempt from registration)
Futures commission merchant
Banking or thrift institution
Trust company
Accountant or accounting firm
Lawyer or law firm
Insurance company or agency
Pension consultant
Real estate broker or dealer
Sponsor or syndicator of limited partnerships
Engineer or engineering firm
Other municipal advisor

Applicant must list on Section 6 of Schedule D all associated persons, including foreign affiliates, that are
broker-dealers, municipal securities dealers, or government securities brokers or dealers, or investment
advisers, municipal advisors, registered swap dealers, banking or thrift institutions, or trust companies.

Item 7

Participation or Interest of Applicant, or of Associated Persons of Applicant, in
Municipal Advisory Client Transactions

Proprietary Interest in Municipal Advisory Client Transactions
A.

Does applicant or any associated person:
(1) buy securities or other investment or derivative products for itself from
clients that it serves or persons that it has solicited or intends to solicit in the context of its municipal
advisory activities, or sell securities it owns to such clients?
 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?
 Yes

 No

(3) enter into derivatives contracts with such clients?

 Yes

8

 No

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(4) recommend securities or other investment or derivative products to such clients 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 Transactions
B. Does applicant or any associated person:
(1) recommend purchases of securities or derivatives to clients that are served by the applicant or
associated person, or persons that the applicant or associated person has solicited or intends to solicit
in the context of its municipal advisory activities, 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 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 that
it serves or person that it has solicited or intends to solicit in the context of its municipal advisory
activities?
 Yes
 No
(2) amount of securities or other investment or derivative products to be bought or sold for the account of
such a client?
 Yes
 No
(3) 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?
 Yes

 No

 Yes

 No

If “yes,” are any of the brokers or dealers associated persons?

(4) commission rates or other fees to be paid to a broker or dealer for such a client’s securities transactions
or transactions in other investment or derivative products?
 Yes
 No
D. Does applicant or any associated person recommend brokers, dealers or investment advisers to clients that
it serves or persons that it has solicited or intends to solicit in the context of its municipal advisory
activities?
 Yes
 No
If “yes,” are any of the brokers, dealers, or investment advisers associated persons?
 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,
including any bonus that is based, at least in part, on the number or amount of such referrals.

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E. Does the applicant or any associated person, directly or indirectly, compensate any person for referrals of
clients in connection with municipal advisory activities?
 Yes
 No
F.

Item 8

Does the applicant or any associated person, directly or indirectly, receive compensation from any person
for referrals of clients in connection with municipal advisory activities?
 Yes
 No

Control Persons

In this Item, identify every person that, directly or indirectly, controls the applicant, or that the applicant
directly or indirectly controls.
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.
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.
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
If yes, complete Section 8-A of Schedule D.
If any person in Schedules A, B, or C, or in Section 8-A of Schedule D is a public reporting company under
Sections 12 or 15(d) of the Securities Exchange Act of 1934, complete Section 8-B of Schedule D.

Item 9

Disclosure Information

In this Item, provide information about the applicant’s disciplinary history and the disciplinary history of all
associated persons 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 of the questions below.
If the answer is “yes” to any question in this Item 9, the applicant must complete the appropriate Disclosure
Reporting Page (“DRP”) – Criminal, Regulatory, etc. – found at the back of this application, as indicated
below.

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

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

10

Yes



No

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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
The response to the following question may be limited to charges that are currently pending:
(2) been charged with a misdemeanor listed in Item 9-B(1)?

 Yes

 No

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:
(1) ever found the applicant or any associated person to have made a false statement or omission, or been
dishonest, unfair, or unethical?
 Yes
 No
(2) ever found the applicant or any associated person to have been involved in a violation of municipal
advisor-related or investment-related regulations or statutes?
 Yes
 No
(3) ever 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) ever entered an order against the applicant or any associated person in connection with a municipal
advisor-related or investment-related activity?
 Yes
 No

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(5) ever 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 of the applicant, 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.

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. 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:
(a) ever enjoined the applicant or any associated person in connection with any municipal advisorrelated or investment-related activity?
 Yes
 No
(b) ever found that the applicant or any associated person was involved in a violation of municipal
advisor-related or investment-related statutes or regulations?
 Yes
 No
(c) ever dismissed, pursuant to a settlement agreement, a municipal advisor-related or investmentrelated civil action brought against the applicant or any associated person by a state or foreign
financial regulatory authority?
 Yes
 No
(2) Is the applicant or any associated person now the subject of any civil proceeding that could
result in a “yes” answer to any part of Item 9-H(1)?
 Yes
 No

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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 Item 10-A 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

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FORM MA
SCHEDULE A
Direct Owners and Executive Officers
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.

2.

Direct Owners and Executive Officers. List below the names of:
(a) 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;
(b) 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 Section 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-in-law, father-in-law, son-in-law, daughter-inlaw, 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.
(c) if the applicant is organized as a partnership, all general partners and those limited and special partners that have the right to receive upon
dissolution, or have contributed, 5% or more of the applicant’s capital;
(d) 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; and
(e) if the applicant is organized as a limited liability company (“LLC”), (i) those members that have the right to receive upon dissolution, or
have contributed, 5% or more of the applicant’s capital, and (ii) if managed by elected managers, all elected managers.

3.

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

4.

In the DE/FE/NP column below, enter “DE” if the owner is a domestic entity, “FE” if the owner is an entity incorporated or domiciled in a
foreign country, or “NP” if the owner or executive officer is a natural person.

5.

Complete the Title or Status column by entering board/management titles; status as partner, trustee, sole proprietor, elected manager,
shareholder, or member; and for shareholders or members, the class of securities owned (if more than one is issued).

6.

Ownership codes are:

NA - less than 5%
A - 5% but less than 10%

Yes

B - 10% but less than 25%
C - 25% but less than 50%

No

D - 50% but less than 75%
E - 75% or more

7.
(a) In the Control Person column, enter “Yes” 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 column, enter “PR” if the owner is a public reporting company under Sections 12 or 15(d) of the Exchange Act.
(c) Complete each column.
FULL LEGAL NAME
(Natural Persons: Last
Name, First Name,
Middle Name)

DE/FE/NP

Title or Status

Date Title or
Status
Acquired
MM

YYYY

14

Ownership
Code

Control Person

Yes/No

PR

CRD No.
(If None: S.S. No. and
Date or Birth, IRS Tax
No., or Employer ID No.)

FORM MA
SCHEDULE B
Indirect Owners
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. Use Schedule C to amend this
information.

2.

Indirect Owners. With respect to each owner listed on Schedule A (except individual owners), list below:
(a) in the case of an owner 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 an owner that is a partnership, all general partners and those limited and special partners that have the right to receive upon
dissolution, or have contributed, 25% or more of the partnership’s capital;
(c) in the case of an owner that is a trust, the trust and each trustee; and
(d) in the case of an owner that is a limited liability company (“LLC”), (i) those members that have the right to receive upon dissolution, or
have contributed, 25% or more of the LLC’s capital, and (ii) if managed by elected managers, all elected managers.

3.

Continue up the chain of ownership listing all 25% owners 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/NP column below, enter “DE” if the indirect owner is a domestic entity, “FE” if the owner is an entity incorporated or domiciled
in a foreign country, or “NP” if the owner is a natural person.

5.

Complete the Status column by entering the indirect owner’s status as partner, trustee, elected manager, shareholder, or member; and for
shareholders or members, 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” 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 column, enter “PR” if the indirect owner is a public reporting company under Sections 12 or 15(d) of the Exchange Act.
(c) Complete each column.
FULL LEGAL
NAME
(Natural Persons:
Last Name, First
Name, Middle Name)

DE/
FE/
NP

Entity in
Which
Interest
is
Owned

Status

Date Title or
Status
Acquired
MM

Ownership
Code

YYYY

Control Person

Yes/No

15

PR

CRD No.
(If None: S.S. No. and
Date or Birth, IRS Tax
No., or Employer ID 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 Schedule A and Schedule B for specific
instructions for completing this Schedule C. Complete each column.

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:

4.

List below all changes to Schedule A (Direct Owners and Executive Officers):

FULL LEGAL
NAME
(Natural Persons:
Last Name, First
Name, Middle Name)

5.

NA - less than 5%
A - 5% but less than 10%
B - 10% but less than 25%

DE/
FE/
NP

Type of
Amendment

C - 25% but less than 50%
D - 50% but less than 75%
E - 75% or more

Title or Status

Date Title or
Status
Acquired
MM

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

Ownership
Code

YYYY

Control
Person

Yes/No

CRD No.
(If None: S.S. No. and
Date or Birth, IRS Tax
No., or Employer ID No.)
PR

List below all changes to Schedule B (Indirect Owners):

FULL LEGAL
NAME
(Natural persons:
Last Name, First
Name, Middle Name)

DE/
FE/
NP

Type of
Amendment

Entity in
Which
Interest
is
Owned

Status

Date Title or
Status
Acquired
MM

16

YYYY

Ownership
Code

Control Person

Yes/No

PR

CRD No.
(If None: S.S. No. and
Date or Birth, IRS Tax
No., or Employer ID No.)

FORM MA
SCHEDULE D
Certain items in Part 1 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.

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.
Check only one box:

Add

Delete

Amend

Name __________________________________________________________ Jurisdictions ______________________________
SECTION 1-D Additional Registrations of the Applicant
Indicate any additional federal or state registration, 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 any additional offices 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. List only the
largest five (in terms of numbers of employees).
Check only one box:

Add

Delete

Amend

__________________________________________________________________________________________________________
(number and street)
__________________________________________________________________________________________________________
(city)
(state/country)
(zip+4/postal code)
If this address is a private residence, check this box:
_____________________________________
(area code) (telephone number)

SECTION 1-F

______________________________________
(area code) (fax number)

Website Addresses

List the applicant’s website addresses. A separate Schedule D must be completed for each website address.
Check only one box:

Add

Delete

Amend

Website Address: ________________________________________________

17

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.
Check only one box:

Add

Delete

Amend

Name of entity where books and records are kept:__________________________________________________________________
__________________________________________________________________________________________________________
(number and street)
__________________________________________________________________________________________________________
(city)
(state/country)
(zip+4/postal code)
If this address is a private residence, check this box:
_____________________________________
(area code) (telephone number)
This is (check one):

______________________________________
(area code) (fax number)

one of applicant’s branch offices or affiliates.
a third-party unaffiliated recordkeeper.
other.

Briefly describe the books and records kept at this location.
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________

SECTION 1-J

Registration with Foreign Financial Regulatory Authorities

List the name, in English, of each foreign financial regulatory authority and 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.
Check only one box:

Add

Delete

Amend

English Name of Foreign Financial Regulatory Authority ___________________________________________________________
Name of Country ___________________________________________________________________________________________

SECTION 1-K Business Affiliates of the Applicant
Provide the name of any business affiliate of the applicant and any federal or state registration of such affiliate and the registration
number. A separate Schedule D must be completed for each such affiliate.
Name of Affiliate _____________________________________________________ Registration No. ________________________

18

SECTION 3

Successions

Complete the following information if succeeding to the business of a currently-registered municipal advisor. If the applicant
acquired more than one municipal advisory firm in the succession being reported on this Form MA, a separate Schedule D must be
completed for each acquired firm. See Instruction 1 of the General Instructions to this Form.
Name of Acquired Municipal Advisory Firm _________________________________________________________
Municipal Advisor

SEC File No.: [MA]- _______________

Municipal Securities Dealer

SEC File No.: ______________

Broker-Dealer

SEC File No.: _______________ CRD No.: _______________

Investment Adviser
SEC-Registered
State Registered

SEC File No.: ___________
CRD No. _______________

Government Securities Broker-Dealer

CRD No.: ______________

SEC File No.: _______________

Other SEC Registration (Specify) ______________________

Bank Identifier ___________

SEC File No. or CIK: ______

Another federal or state regulator (Specify) ______________________ Registration No.: __________

SECTION 4-D Firms that Solicit Municipal Advisor Clients on the Applicant’s Behalf
Provide the name, address, and phone number of any firm 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.
Name of Firm ____________________________________________
__________________________________________________________________________________________________________
(number and street)
__________________________________________________________________________________________________________
(city)
(state/country)
(zip+4/postal code)
_____________________________________
(area code) (telephone number)

______________________________________
(area code) (fax number)

SECTION 5-B Description of Primary Business (when primary business is not business as municipal advisor)
Describe the applicant’s primary business (not the applicant’s municipal advisor-related business):
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________

19

SECTION 6

Financial Industry Affiliations

The following information must be completed for each associated person that is a municipal advisor, broker-dealer, municipal
securities dealer, government securities broker or dealer, investment adviser, registered swap dealer, banking or thrift institution, or
trust company, foreign or domestic. A separate Schedule D must be completed for each listed associated person.
Check only one box:

Add

Delete

Amend

Legal Name of Associated Person: ________________________________________________________________
Primary Business Name of Associated Person: ___________________________________________________________
Associated person is a (check all that apply):
Broker-Dealer, Municipal Securities Dealer, or Government Securities Broker or Dealer
Government Securities Broker or Dealer
Swap Dealer

Pension Consultant

Banking or Thrift Institution

Trust Company

Investment Company (including mutual funds)

Investment Adviser (including financial planners)

Security-Based Swap Dealer

Major Swap Participant

Major Security-Based Swap Participant

Futures Commission Merchant

Commodity Pool Operator (whether registered or exempt from registration)

Commodity Trading Advisor (whether registered or exempt from registration)
Sponsor or Syndicator of Limited Partnerships

Accountant or Accounting Firm

Lawyer or Law Firm

Engineer or Engineering Firm
Other Municipal Advisor
1.

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

Yes

No

2.

Are the applicant and the associated person under common control?

Yes

No

3.

(a) Is the associated person registered with a foreign financial regulatory authority?
Yes
No
(b) If the answer to 3(a) is “yes”, list the name, in English, of each foreign financial regulatory authority and country with which
the associated person is registered.
___________________________________________________________________________________

20

SECTION 8

Control Persons

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.
Check only one box:

Add

Delete

Amend

If control person is a firm or organization:
Name______________________________________________________________________________________________
Municipal Advisor
Effective Date _________________
mm/dd/yyyy

SEC File No.: _______________
Termination Date _________________
mm/dd/yyyy

Municipal Securities Dealer
Effective Date _________________
mm/dd/yyyy

SEC File No.: ______________
Termination Date _________________
mm/dd/yyyy

Broker-Dealer
Effective Date _________________
mm/dd/yyyy

SEC File No.: ___________
CRD No.: _____________
Termination Date _________________
mm/dd/yyyy

Investment Adviser
SEC-Registered
SEC File No.: ___________
CRD No.: ______________
Effective Date ________________ Termination Date _________________
mm/dd/yyyy
mm/dd/yyyy
State Registered
CRD No. _______________
Effective Date ________________ Termination Date _________________
mm/dd/yyyy
mm/dd/yyyy
Government Securities Broker-Dealer
Effective Date _________________
mm/dd/yyyy

SEC File No.: _______________ Bank Identifier ___________
Termination Date _________________
mm/dd/yyyy

Other SEC Registration (Specify) ______________________
SEC File No. or CIK: ______
Effective Date _________________
Termination Date _________________
mm/dd/yyyy
mm/dd/yyyy
Another federal or state regulator (Specify) ______________________
Registration No.: __________
Effective Date _________________
Termination Date _________________
mm/dd/yyyy
mm/dd/yyyy

21

Business Address:
__________________________________________________________________________________________________________
(number and street)
__________________________________________________________________________________________________________
(city)
(state/country)
(zip+4/postal code)
If this address is a private residence, check this box:
If control person is a natural person:
Name (Last, First, Middle) ___________________________________________________________________________
CRD Number (if any) _______________________ Effective Date _________________ Termination Date _________________
mm/dd/yyyy
mm/dd/yyyy
Business Address:
__________________________________________________________________________________________________________
(number and street)
__________________________________________________________________________________________________________
(city)
(state/country)
(zip+4/postal code)
If this address is a private residence, check this box:
Briefly describe the nature of the control:
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
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 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 CIK number (Central Index Key number that the SEC assigns to each reporting company):
________________

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

22

CRIMINAL ACTION DISCLOSURE REPORTING PAGE (MA)
GENERAL INSTRUCTIONS
This Disclosure Reporting Page (DRP MA) is an
responses to Items 9-A or 9-B of Form MA.
Check item(s) being responded to:

INITIAL OR

9-A(1)

9-A(2)

AMENDED response used to report details for affirmative

9-B(1)

9-B(2)

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. File with a completed Execution Page.
Multiple counts of the same charge arising out of the same event(s) should be reported on the same DRP. Use this DRP to report all
charges arising out of the same event. Unrelated criminal actions, including separate cases arising out of the same event, must be
reported on separate DRPs. One event may result in more than one affirmative answer to the items listed above.
PART I
Check all that apply:
A. The person(s) or entity(ies) for whom this DRP is being filed is (are) the:
Applicant
Applicant and one or more associated persons
One or more of applicant’s associated persons
If this DRP is being filed for the applicant, and it is an amendment that seeks to remove a DRP concerning the applicant from the
record, 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.
If this DRP is being filed for an associated person:
This associated person is:
The associated person is:

a firm
a natural person
registered with the SEC
not registered with the SEC

Full name of the associated person (including, for natural persons, last, first and middle names):
____________________________________________________
If the associated person has a CRD number, provide that number. __________
If this is an amendment that seeks to remove a DRP concerning the associated person, 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. If the municipal advisor or associated person is registered through the IARD system or CRD system, or if the municipal advisor
previously registered with the SEC on Form MA-T, has the municipal advisor or associated person previously submitted a DRP
(with Form ADV, BD, or U4) to the IARD or CRD, or has the municipal advisor filed disclosure on Form MA-T, for the event
that contains the information required by this DRP?
Yes
No
If the answer is “Yes,” no other information on this DRP must be provided.
NOTE: The completion of this form does not relieve the municipal advisor or associated person of its obligation to update its IARD
or CRD records.
23

PART II
1.

If charge(s) were brought against a firm or organization over which the applicant or an associated person exercised control:

Enter the firm or organization’s name __________________________________________
Was the firm or organization engaged in a municipal advisor-related business?

Yes

No

What was the relationship of the applicant with the firm or organization? (In the case of an associated person, include any position or
title with the firm or organization.)
____________________________________________________________________________
2.

Formal charge(s) were brought in: (include the name of Federal, Military, State or Foreign Court, Location of Court - City or
County and State or Country, and Docket/Case number).

Name of court: _________________________
Location: _____________________________
Docket/Case number: ____________________
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. Event Disclosure Detail (include charge(s)/charge Description(s), and for each charge provide: (1) number of counts, (2)
felony or misdemeanor, (3) plea for each charge, and (4) product type if charge is municipal advisor-related or investmentrelated).
______________________________________________________________________________________________________
______________________________________________________________________________________________________
C. Did any of the charge(s) within the event involve a felony?

Yes

D. Current status of the event?

Final

Pending

On Appeal

No

E. Event status date (Complete unless status is pending) (MM/DD/YYYY): ____________________
Exact
Explanation
If not exact, provide explanation:
______________________________________________________________________________________________________
______________________________________________________________________________________________________
4.

Disposition Disclosure Detail: Include for each charge (a) Disposition Type (e.g., convicted, acquitted, dismissed, pretrial, etc.),
(b) Date, (c) Sentence/Penalty, (d) Duration (if sentence-suspension, probation, etc.), (e) Start Date of Penalty, (f) Penalty/Fine
Amount, and (g) Date Paid.
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
5.

Provide a brief summary of circumstances leading to the charge(s) as well as the disposition. Include the relevant dates when the
conduct which was the subject of the charge(s) occurred. (The response must fit within the space provided.)
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________

24

REGULATORY ACTION DISCLOSURE REPORTING PAGE (MA)
GENERAL INSTRUCTIONS
This Disclosure Reporting Page (DRP MA) is an
INITIAL OR
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-D(1)
9-E(1)
9-F

9-C(2)
9-D(2)
9-E(2)
9-G

AMENDED response used to report details for affirmative

9-C(3)
9-D(3)
9-E(3)

9-C(4)
9-D(4)
9-E(4)

9-C(5)
9-D(5)

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. File with a completed Execution Page.
One event may result in more than one affirmative answer to Items 9-C, 9-D, 9-E, 9-F or 9-G. Use only one DRP to report details
related to the same event. If an event gives rise to actions by more than one regulator, provide details for each action on a separate
DRP.
PART I
A. The person(s) or entity(ies) for whom this DRP is being filed is (are) the:
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)
If this DRP is being filed for the applicant, and it is an amendment that seeks to remove a DRP concerning the applicant from the
record, 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.
If this DRP is being filed for an associated person:
This associated person is:
The associated person is:

a firm
a natural person
registered with the SEC
not registered with the SEC

Full name of the associated person (including, for natural persons, last, first and middle names):
____________________________________________________
If the associated person has a CRD number, provide that number. __________
If this is an amendment that seeks to remove a DRP concerning the associated person, 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:
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
C. If the municipal advisor or associated person is registered through the IARD system or CRD system, or if the municipal advisor
previously registered with the SEC on Form MA-T, has the municipal advisor or associated person previously submitted a DRP
(with Form ADV, BD, or U4) to the IARD or CRD, or has the municipal advisor filed disclosure on Form MA-T, for the event
that contains the information required by this DRP?
Yes
No
If the answer is “Yes,” no other information on this DRP must be provided.
NOTE: The completion of this form does not relieve the municipal advisor or associated person of its obligation to update its IARD
or CRD records.
25

PART II
1.

Regulatory Action was initiated by:
SEC

Other Federal Authority

State

SRO

Foreign Authority

(Full name of regulator, foreign financial regulatory authority, federal authority, state or SRO)
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
2.

Principal Sanction (check appropriate item):
Civil and Administrative Penalty(ies)/Fine(s)
Bar
Cease and Desist
Censure
Denial

Disgorgement
Expulsion
Injunction
Prohibition
Reprimand

Restitution
Revocation
Suspension
Undertaking
Other ______________

Other Sanctions:
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
3.

Date Initiated (MM/DD/YYYY): ____________________

Exact

Explanation

If not exact, provide explanation:
______________________________________________________________________________________________________
______________________________________________________________________________________________________
4.

Docket/Case Number: ____________________

5. Associated person’s Employing Firm when activity occurred which led to the regulatory action (if applicable):
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
6.

Principal Product Type (check appropriate item):
Annuity(ies) - Fixed
Annuity(ies) - Variable
CD(s)
Commodity Option(s)
Debt - Asset Backed
Debt - Corporate
Debt - Government
Debt - Municipal

Derivative(s)
Direct Investment(s) - DPP & LP Interest(s)
Equity - OTC
Equity Listed (Common & Preferred Stock)
Futures - Commodity
Futures - Financial
Index Option(s)
Insurance

Investment Contract(s)
Money Market Fund(s)
Mutual Fund(s)
No Product
Options
Penny Stock(s)
Unit Investment Trust(s)
Other ______________

Other Product Types:
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
7. Describe the allegations related to this regulatory action. (The response must fit within the space provided.)
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________

26

8.

Current status?

Pending

On Appeal

Final

9. If on appeal, to whom the regulatory action was appealed (SEC, SRO, Federal or State Court) and date appeal filed:
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
If Final or On Appeal, complete all items below. For Pending Actions, complete Item 13 only.
10. How was matter resolved (check appropriate item):
Acceptance, Waiver & Consent (AWC)
Consent
Decision
Decision & Order of Offer of Settlement

Dismissed
Order
Settled
Stipulation and Consent

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

Exact

Vacated
Withdrawn
Other ______________

Explanation

If not exact, provide explanation:
______________________________________________________________________________________________________
______________________________________________________________________________________________________
12. Resolution Detail:
A. Were any of the following Sanctions Ordered (check all appropriate items)?
Monetary/Fine
Amount: $______________

Revocation/Expulsion/Denial
Censure

Disgorgement/Restitution
Cease and Desist/Injunction

Bar

Suspension

B. Other Sanctions Ordered:
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
C. Sanction detail: if suspended, enjoined or barred, provide duration including start date and capacities affected (General
Securities Principal, Financial Operations Principal, etc.). If requalification by exam/retraining was a condition of the
sanction, provide length of time given to requalify/retrain, type of exam required and whether condition has been satisfied. If
disposition resulted in a fine, penalty, restitution, disgorgement or monetary compensation, provide total amount, portion
levied against the applicant or an associated person, date paid and if any portion of penalty was waived:
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
13. Provide a brief summary of details related to the action status and (or) disposition and include relevant terms, conditions and
dates.
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________

27

CIVIL JUDICIAL ACTION DISCLOSURE REPORTING PAGE (MA)
GENERAL INSTRUCTIONS
This Disclosure Reporting Page (DRP MA) is an
responses to Item 9-H. of Form MA.

INITIAL OR

Check item(s) being responded to:

9-H(1)(b)

9-H(1)(a)

AMENDED response used to report details for affirmative

9-H(1)(c)

9-H(2)

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. File with a completed Execution Page.
One event may result in more than one affirmative answer to Item 9-H. Use only one DRP to report details related to the same event.
Unrelated civil judicial actions must be reported on separate DRPs.
PART I
A. The person(s) or entity(ies) for whom this DRP is being filed is (are) the:
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)
If this DRP is being filed for the applicant, and it is an amendment that seeks to remove a DRP concerning the applicant from the
record, 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.
If this DRP is being filed for an associated person:
This associated person is:
The associated person is:

a firm
a natural person
registered with the SEC
not registered with the SEC

Full name of the associated person (including, for natural persons, last, first and middle names):
____________________________________________________
If the associated person has a CRD number, provide that number. __________
If this is an amendment that seeks to remove a DRP concerning the associated person, 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:
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
D. If the municipal advisor or associated person is registered through the IARD system or CRD system, or if the municipal advisor
previously registered with the SEC on Form MA-T, has the municipal advisor or associated person previously submitted a DRP
(with Form ADV, BD, or U4) to the IARD or CRD, or has the municipal advisor filed disclosure on Form MA-T, for the event
that contains the information required by this DRP?
Yes
No
If the answer is “Yes,” no other information on this DRP must be provided.
NOTE: The completion of this form does not relieve the municipal advisor or associated person of its obligation to update its IARD
or CRD records.

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PART II
1.

Court Action initiated by: (Name of regulator, foreign financial regulatory authority, SRO, commodities exchange, agency, firm,
private plaintiff, etc.)

2.

Principal Relief Sought (check appropriate item):
Cease and Desist
Civil Penalty(ies)/Fine(s)

Disgorgement
Injunction

Money Damages (Private/Civil Complaint)
Restitution

Restraining Order
Other _________

Other Relief Sought:
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
3.

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

Exact

Explanation

If not exact, provide explanation:
______________________________________________________________________________________________________
______________________________________________________________________________________________________
4.

Principal Product Type (check appropriate item):
Annuity(ies) - Fixed
Annuity(ies) - Variable
CD(s)
Commodity Option(s)
Debt - Asset Backed
Debt - Corporate
Debt - Government
Debt - Municipal

Derivative(s)
Direct Investment(s) - DPP & LP Interest(s)
Equity - OTC
Equity Listed (Common & Preferred Stock)
Futures - Commodity
Futures - Financial
Index Option(s)
Insurance

Investment Contract(s)
Money Market Fund(s)
Mutual Fund(s)
No Product
Options
Penny Stock(s)
Unit Investment Trust(s)
Other ______________

Other Product Types:
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
5.

Formal Action was brought in (include the name of the Federal, State or Foreign Court, Location of Court - City or County and
State or Country, and Docket/Case Number):
__________________________________________________________________________________________________________
6. Associated person’s Employing Firm when activity occurred which led to the civil judicial action (if applicable):
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
7. Describe the allegations related to this civil action (the response must fit within the space provided):
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________

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8.

Current status?

Pending

On Appeal

Final

9. If on appeal, court to which the action was appealed (provide name of the court) and Date Appeal Filed (MM/DD/YYYY):
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
10. If pending, date notice/process was served (MM/DD/YYYY): ____________________

Exact

Explanation

If not exact, provide explanation:
______________________________________________________________________________________________________
______________________________________________________________________________________________________
If Final or On Appeal, complete all items below. For Pending Actions, complete Item 14 only.
11. How was matter resolved (check appropriate item):
Consent
Dismissed

Judgment Rendered
Opinion

Settled
Withdrawn

Other _____________

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

Exact

Explanation

If not exact, provide explanation:
______________________________________________________________________________________________________
______________________________________________________________________________________________________
13. Resolution Detail:
A. Were any of the following Sanctions Ordered or Relief Granted (check appropriate items)?
Monetary/Fine
Amount: $______________

Revocation/Expulsion/Denial
Censure

Disgorgement/Restitution
Cease and Desist/Injunction

Bar

Suspension

B. Other Sanctions Ordered:
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
C. Sanction detail: If suspended, enjoined or barred, provide duration including start date and capacities affected (General
Securities Principal, Financial Operations Principal, etc.). If requalification by exam/retraining was a condition of the
sanction, provide length of time given to requalify/retrain, type of exam required and whether condition has been satisfied. If
disposition resulted in a fine, penalty, restitution, disgorgement or monetary compensation, provide total amount, portion
levied against the applicant or an associated person, date paid and if any portion of penalty was waived:
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
14. Provide a brief summary of circumstances related to the action(s), allegation(s), disposition(s) and/or finding(s) disclosed above.
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________

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