|
REGISTERED SECURITIES PRINCIPAL
for a Non-NASD firm
APPLICANT CERTIFICATION
I,
______________________________, CRD number _____________, in connection with my application to register as a principal of
_______________________________________________________________, hereby certify to
the Administrator of the Oklahoma Department of Securities that:
- I have carefully reviewed the Oklahoma Uniform Securities Act of 2004, 71 O.S., §§ 1-101 through 1-701,
as well as the rules and regulations adopted thereto, and I fully understand my responsibilities there under as a registered principal, including but not limited to, my
responsibility for the supervision of all agents of said broker-dealer who are registered in the
State of Oklahoma; and
- All information concerning myself as filed on the Form U-4 with the Central Registration
Depository (CRD) or as filed on the Form U-4 directly with the Administrator of the
Oklahoma Department of securities is true and correct and a correcting amendment shall be
promptly filed when such information becomes inaccurate or incomplete in any material
respect.
| Dated this _____day of
_____________. 20___. |
|
|
______________________________________________
|
|
(Signature)
|
| STATE
OF.......................................................... |
) |
|
) SS |
| COUNTY
OF...................................................... |
) |
| Subscribed and sworn before me this _____ day of
____________, 20 ____. |
|
_______________________________________
|
|
My Commission Expires:____________________ |
Notary Public
|
MANAGEMENT CERTIFICATION
I,
_______________________________________, an officer, director, partner or sole proprietor
of _____________________________________________________________________, hereby certify to the Administrator of the
Oklahoma Department of Securities that the above applicant for registration as
a principal has been provided adequate instruction with respect to
his/her responsibilities under the
Oklahoma Uniform Securities Act of 2004, and the rules and regulations.
| Dated this _____day of _____________. 20___.
|
|
|
_____________________________________________
|
|
(Signature)
|
|
_____________________________________________
|
|
(Title)
|
| STATE
OF.......................................................... |
) |
|
) SS |
| COUNTY
OF...................................................... |
) |
| Subscribed and sworn before me this _____ day of
____________, 20 ____. |
|
_______________________________________
|
|
My Commission Expires:____________________ |
Notary Public
|
|