Form 7A - Application for transfer/change of status [F - Rescinded]
Published Date: | 1990-05-11 |
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Effective Date: | 1990-06-15 |
Rescinded Date: | 1996-09-01 |
Form 7A
Application for Transfer / Change of Status
Check one (/) Securities Act [] Commodity Contract Act []
FOR INTERNAL USE ONLY
____________________________________________
APPLICATION APPROVED BY DATE APPROVED
____________________________________________
Name of Applicant:
______________________________________________
Residential address (Include Postal Code):
______________________________________________
Name of employer:
______________________________________________
Address where Applicant will be working (Include Postal Code):
______________________________________________
Address for service in the Province (Include Postal Code):
______________________________________________
Applying for registration as:
______________________________________________
[] TRANSFER [] CHANGE OF STATUS
A. TRANSFER
Name of previous employer:
______________________________________________
Date of termination:
______________________________________________
B. CHANGE OF STATUS
CURRENT REGISTRATION:
______________________________________________
Applicable examination written
(Attach proof of passing): Date passed:
_________________________ ____________________
__________________________ ____________________
___________________________ ____________________
HAVE THERE BEEN CHANGES IN THE INFORMATION GIVEN IN QUESTIONS 11 THROUGH 20 (SEE REVERSE) OF THE UNIFORM APPLICATION FOR REGISTRATION / APPROVAL PREVIOUSLY FILED BY YOU AND APPROVED?
CIRCLE ONE: YES / NO. IF YES, ATTACH FULL PARTICULARS.
The undersigned hereby certify that the foregoing statements are true and correct to the best of our knowledge, information and belief (after having seen the Uniform Application for Registration / Approval and all subsequent Applications for Transfer / Change of Status previously filed by the applicant) and we hereby undertake to notify the British Columbia Securities Commission in writing, of any change therein within the period prescribed by the British Columbia Securities Act, Commodity Contract Act or regulations of either Act.
___________________________ ____________________________
Date Signed Signature of Applicant
____________________________ ____________________________
Print Name of Partner, Director or Signature of Partner, Director of Officer
Officer of the Dealer, Adviser or
Underwriter that employs the Applicant
NOTE: The following areas are addressed in the Uniform Application and constitute questions 11 through 20 respectively:
CHANGE OF NAME
PRIOR REGISTRATION OR LICENSING
REFUSAL, SUSPENSION, CANCELLLATION OR DISCIPLINARY MEASURE
SELF - REGULATORY ORGANIZATIONS
OFFENCES UNDER THE LAW
CIVIL PROCEEDINGS
BANKRUPTCY
JUDGMENT OR GARNISHMENT
SURETY BOND OR FIDELITY BOND
BUSINESS ACTIVITIES