Form SFN54147 "Application for Registration of Securities by Announcement - Secondary" - North Dakota

What Is Form SFN54147?

This is a legal form that was released by the North Dakota Securities Department - a government authority operating within North Dakota. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 2013;
  • The latest edition provided by the North Dakota Securities Department;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form SFN54147 by clicking the link below or browse more documents and templates provided by the North Dakota Securities Department.

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Download Form SFN54147 "Application for Registration of Securities by Announcement - Secondary" - North Dakota

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Securities Department
APPLICATION FOR REGISTRATION OF
600 E Boulevard Ave - Dept 414
SECURITIES BY ANNOUNCEMENT - SECONDARY
Bismarck, ND 58505
SECURITIES DEPARTMENT
(701) 328-2910
SFN 54147 (10-2013)
www.nd.gov/securities
Under Section 10-04-07.1 of the Securities Act of 1951 as amended.
Dealer Applicant
Address
City
State
ZIP Code
Name of Issuer of Securities Being Registered
Principal Office Address
City
State
ZIP Code
Title of Securities Being Registered
Current Market
Bid
Ask
Last Twelve Month High
Last Twelve Month High
Last Twelve Month High
Last Twelve Month Low
Last Twelve Month Low
Last Twelve Month Low
Bid
Ask
Bid
Ask
Earnings History per share for 5 years (except for newer companies)
1
2
3
4
5
Average for Period
Subject securities have been outstanding and in the hands of the public for not less than one year.
No
Yes
Include a financial statement or Offering Circular containing a financial statement not more than 12 months old. If not available, indicate date when ready.
Subject Securities Previously Registered
Date of Latest Registration
In North Dakota
With Securities & Exchange Commission
If the securities being registered are life insurance company stocks qualifying under the second paragraph of Section 10-04-
07.1 of the North Dakota Securities Act of 1951, as amended, please supply information as stated in Subsection 1 of Section
10-04-07.1.
Securities entitled to registration by announcement may be registered only by a dealer registered with the Securities
Department.
The filling fee is twenty-five dollars ($25.00).
The undersigned under oath says that he/she has executed the foregoing application for and on behalf of the applicant
named above; that he/she is ___________________________ of such applicant and is fully authorized to execute and file
such application; that he/she has read such application and knows the contents; and that to the best of his/her knowledge and
belief the statement made in such application and the exhibits enclosed are true.
Registered Dealer
Date
Corporate
Seal
Printed Name of Signatory
By
Signature and Official Capacity of Person Filing for Registered Dealer
Securities Department
APPLICATION FOR REGISTRATION OF
600 E Boulevard Ave - Dept 414
SECURITIES BY ANNOUNCEMENT - SECONDARY
Bismarck, ND 58505
SECURITIES DEPARTMENT
(701) 328-2910
SFN 54147 (10-2013)
www.nd.gov/securities
Under Section 10-04-07.1 of the Securities Act of 1951 as amended.
Dealer Applicant
Address
City
State
ZIP Code
Name of Issuer of Securities Being Registered
Principal Office Address
City
State
ZIP Code
Title of Securities Being Registered
Current Market
Bid
Ask
Last Twelve Month High
Last Twelve Month High
Last Twelve Month High
Last Twelve Month Low
Last Twelve Month Low
Last Twelve Month Low
Bid
Ask
Bid
Ask
Earnings History per share for 5 years (except for newer companies)
1
2
3
4
5
Average for Period
Subject securities have been outstanding and in the hands of the public for not less than one year.
No
Yes
Include a financial statement or Offering Circular containing a financial statement not more than 12 months old. If not available, indicate date when ready.
Subject Securities Previously Registered
Date of Latest Registration
In North Dakota
With Securities & Exchange Commission
If the securities being registered are life insurance company stocks qualifying under the second paragraph of Section 10-04-
07.1 of the North Dakota Securities Act of 1951, as amended, please supply information as stated in Subsection 1 of Section
10-04-07.1.
Securities entitled to registration by announcement may be registered only by a dealer registered with the Securities
Department.
The filling fee is twenty-five dollars ($25.00).
The undersigned under oath says that he/she has executed the foregoing application for and on behalf of the applicant
named above; that he/she is ___________________________ of such applicant and is fully authorized to execute and file
such application; that he/she has read such application and knows the contents; and that to the best of his/her knowledge and
belief the statement made in such application and the exhibits enclosed are true.
Registered Dealer
Date
Corporate
Seal
Printed Name of Signatory
By
Signature and Official Capacity of Person Filing for Registered Dealer