Form SFN51532 (S-6) "Issuer Dealer Renewal Application" - North Dakota

What Is Form SFN51532 (S-6)?

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 SFN51532 (S-6) by clicking the link below or browse more documents and templates provided by the North Dakota Securities Department.

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Download Form SFN51532 (S-6) "Issuer Dealer Renewal Application" - North Dakota

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FORM S - 6
ISSUER DEALER RENEWAL APPLICATION
Securities Department
NORTH DAKOTA SECURITIES DEPARTMENT
600 E Boulevard Ave Dept 414
SFN 51532 (10-2013)
Bismarck ND 58505
(701) 328-2910
www.nd.gov/securities
NOTE:
Registration of Dealers and Agents may be renewed each year at any time not less than 15 and not more than 30 days before
December 31. This form is to be completed for dealer renewal or termination purposes.
RENEWAL
TERMINATE
(OR)
NOTE: If a firm is terminated, the agent(s), if any, will also be terminated.
1. Name of Firm Registered as Issuer/Dealer
Telephone Number
Address
City
State
ZIP Code
Contact Person
2. State the name of each registered agent to be renewed (attach a separate sheet if needed). A termination notice in letter form must be
filed for each agent whose registration will not be renewed and, if applicable, an application (Form S-5) must be completed for each new
http://www.nd.gov/eforms/Doc/sfn51529.pdf
applicant. The Form S-5 is available at
3. It is hereby certified that since the last dealer renewal date, the North Dakota Securities Department has been notified by this dealer in
writing of all material changes, if any, of a substantial nature that have taken place affecting the dealer, its officers, directors, partners,
managers, agents, and employees. This would include any disciplinary action or other proceedings that have been taken by any
federal or state agency or by any national securities exchange or national securities association.
Yes
No
If "No", indicate exhibit here
4. It is further certified that in all cases where agents have left our employ for whatever reason, that a termination notice has been filed with
the North Dakota Securities Department.
Yes
No
5.
Describe the principal types of business engaged in by the applicant and types of securities being sold.
6.
Enclose payment of proper fee for renewal of dealer and agents as provided in the North Dakota Securities Act:
For each dealer in this state: $200.00
AND
For each applicant to be renewed and/or new registration filing: $60.
Dated this
day of
, year
.
Print Name of Person Signing for Dealer
(Corporate Seal)
Signature of Person Signing for the Registered Dealer
Title
FORM S - 6
ISSUER DEALER RENEWAL APPLICATION
Securities Department
NORTH DAKOTA SECURITIES DEPARTMENT
600 E Boulevard Ave Dept 414
SFN 51532 (10-2013)
Bismarck ND 58505
(701) 328-2910
www.nd.gov/securities
NOTE:
Registration of Dealers and Agents may be renewed each year at any time not less than 15 and not more than 30 days before
December 31. This form is to be completed for dealer renewal or termination purposes.
RENEWAL
TERMINATE
(OR)
NOTE: If a firm is terminated, the agent(s), if any, will also be terminated.
1. Name of Firm Registered as Issuer/Dealer
Telephone Number
Address
City
State
ZIP Code
Contact Person
2. State the name of each registered agent to be renewed (attach a separate sheet if needed). A termination notice in letter form must be
filed for each agent whose registration will not be renewed and, if applicable, an application (Form S-5) must be completed for each new
http://www.nd.gov/eforms/Doc/sfn51529.pdf
applicant. The Form S-5 is available at
3. It is hereby certified that since the last dealer renewal date, the North Dakota Securities Department has been notified by this dealer in
writing of all material changes, if any, of a substantial nature that have taken place affecting the dealer, its officers, directors, partners,
managers, agents, and employees. This would include any disciplinary action or other proceedings that have been taken by any
federal or state agency or by any national securities exchange or national securities association.
Yes
No
If "No", indicate exhibit here
4. It is further certified that in all cases where agents have left our employ for whatever reason, that a termination notice has been filed with
the North Dakota Securities Department.
Yes
No
5.
Describe the principal types of business engaged in by the applicant and types of securities being sold.
6.
Enclose payment of proper fee for renewal of dealer and agents as provided in the North Dakota Securities Act:
For each dealer in this state: $200.00
AND
For each applicant to be renewed and/or new registration filing: $60.
Dated this
day of
, year
.
Print Name of Person Signing for Dealer
(Corporate Seal)
Signature of Person Signing for the Registered Dealer
Title