Reporting Form MSD-5

INSTRUCTIONS FOR PREPARATION OF

The Uniform Termination Notice for
Municipal Securities Principal or
Municipal Securities Representative
Associated with a Bank Municipal
Securities Dealer
Form MSD-5
General instructions
(1) As used in these instructions and Form MSD-5,
the term bank municipal securities dealer means
a municipal securities dealer that is a bank or a
department or division of a bank.
(2) Form MSD-5 is intended for use by bank
municipal securities dealers in reporting the termination of a municipal securities principal’s or
municipal securities representative’s association
with such dealer.
(3) Bank municipal securities dealers are required to
file Form MSD-5 with the appropriate regulatory agency as set forth below:
a. A bank municipal securities dealer that is a
state member bank of the Federal Reserve
System, a department or division of any such
bank, a bank holding company (including a
subsidiary bank of the bank holding company if the subsidiary is not otherwise
instructed to file this form with the Federal
Deposit Insurance Corporation or the
Comptroller of the Currency in subparagraphs (b) or ( c) of this paragraph or with
the Securities and Exchange Commission,
and a division, department or subsidiary of
that subsidiary), a savings and loan holding
company, or a State branch or agency of a
foreign bank is required to file with the
Board of Governors of the Federal Reserve
System.
b. A bank municipal securities dealer that is a
bank insured by the Federal Deposit Insurance Corporation (other than a Federal
Reserve System member bank) or a department or division of any such bank is

required to file with the Federal Deposit
Insurance Corporation.
c. A bank municipal securities dealer that is a
national bank or bank operating under the
Code of Law for the District of Columbia or
a department or division of any such bank is
required to file with the Comptroller of the
Currency.
(4) Copies of Form MSD-5 may be obtained from
any one of the regulatory agencies listed in
instruction 3.
(5) Bank municipal securities dealers that file with
the Federal Deposit Insurance Corporation may
either mail an original and one copy of Form
MSD-5 and any attachments within thirty days
after termination of the association with the
individual named in item 1 or, alternatively, submit an electronic copy of the form (available at
www.fdic.gov) and attachments, in Portable Document Format (“PDF”) to the secure
email address [email protected] within thirty days after
termination of association with the individual
named in item 1. Bank municipal securities dealers that file with the Comptroller of the Currency must submit an electronic copy of the
form and attachments to the OCC’s BankNet
website at www.banknet.gov within thirty days
after termination of the association with the
individual named in item 1. A bank municipal
securities dealer filing Form MSD-5 shall retain
an exact copy in its records for at least three
years after the applicant’s employment or other
association with such dealer has terminated.
(6) A bank municipal securities dealer required to
file with the Board of Governors of the Federal
Reserve System must submit an electronic copy
GEN-1

Form MSD-5

March 2017

Form MSD-5

of the form and attachments to the secure email
address [email protected].
Report the form and attachments in Portable Document Format (“PDF”). Form
MSD-5 must be submitted within thirty days
after termination of the association with the
individual named in item 1. A bank municipal
securities dealer filing Form MSD-5 shall retain
an exact copy in its records for at least three
years after the applicant’s employment or other
association with such dealer has terminated.
(7) If more space is needed to complete an answer,
an appropriate designation shall be entered in
the answer space provided, and one or more
attachment sheets shall be used to complete the
response. All attachments shall be submitted in
the same format as the items to which response
is made and should be typed on white 8-1/2 x 11
in. paper. The answers to more than one question may appear on an attachment sheet if the
questions are clearly identified. Attachments
should be paginated and the name of both the
person terminated and the bank municipal securities dealer should appear on every attachment
sheet.
(8) Form MSD-5 and any attachments may be
duplicated by any method which produces legible copies of type size identical to that of the
Form MSD-5 on white 8-1/2 x11 in. paper.
(9) Form MSD-5 shall be manually signed on page
1 (bottom) by a municipal securities principal of
the employing bank municipal securities dealer.

(10) All items on Form MSD-5 must be completed.
The date on which Form MSD-5 is received by
the appropriate regulatory agency shall be the
date of filing. A Form MSD-5 that is not prepared and executed in accordance with the
applicable requirements may be returned as
unacceptable. Acceptance for filing shall not
constitute any finding that a Form MSD-5 has
been completed in accordance with those
requirements or that any information reported
on the form is true, current, complete, or not
misleading.
(11) Section 17(c)(1) of the Securities Exchange Act
of 1934 requires every bank municipal securities
dealer that files any application, notice, report,
or document with its appropriate regulatory
agency to file a copy of that application, notice,
report, or document with the Securities and
Exchange Commission (SEC). The SEC and the
appropriate regulatory agencies listed in instruction 3 have developed procedures under which
the latter will transmit a copy of any application, notice, report, or document filed with them
by a bank municipal securities dealer to the
SEC. Accordingly, when this form is filed with
the appropriate regulatory agency, it will be
deemed to have been filed with the SEC.
(12) If this form is being filed in lieu of Form
G-FIN-5, check all applicable types of
qualifications requested in item 2.

GEN-2
March 2019

Form MSD-5