Request for Record Inspection

Name
Street
City	State	Zip
E-Mail*	Daytime Phone

RECORD REQUESTED: Please provide a specific description of the record(s) in question. If you are requesting information on Broker-dealers, Agents, Investment Advisers, or Investment Adviser Representatives, please provide the full name and CRD # of the individual or firm.

Record Title, Case Reference#, Description, Entity, Date, CRD #, etc.
1.
2.
3.

General Purpose of Request:

If this request is deemed to be for commercial purposes, a $20/hr research charge will apply.

Charges that may apply:

For printed pages there is a $0.25 per page copy fee pursuant to section 1-612 of the Oklahoma Uniform Securities Act of 2004 (OUSA of 2004)
Requests that are determined to be for commercial purposes will be charged a research fee of $20.00 per hour. This fee is in addition to the copy fee above. Payment for commercial purpose requests is due prior to the work being performed.
Information that will satisfy a request that is available in an electronic format and can be transmitted via e-mail, may not incur the above stated copy fee. Examples would include WebCRD firm and individual snapshot requests.

You will be notified, in advance, of charges to be incurred.