31-901F - Application for Registration as a Dealer or Adviser [Proposed F - Lapsed]
| Published Date: | 2004-06-25 |
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| Document(s): |
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FORM 31-901F
Application for Registration as a Dealer or Adviser
This is the form of application required under section 21 of the Rules.
Italicized terms are defined in the Securities Act or Rules.
Application for Registration as a Dealer or Adviser
This is the form of application required under section 21 of the Rules.
Italicized terms are defined in the Securities Act or Rules.
1. Contact Information
(a) Applicant name:
(i) Name of contact individual responsible for this application,
(ii) Phone number of contact individual,
(iii) General phone number (if different),
(iv) General fax number,
(v) E-mail address of contact individual,
(ii) Phone number of contact individual,
(iii) General phone number (if different),
(iv) General fax number,
(v) E-mail address of contact individual,
(b) Head office address,
Website address,
(c) If your head office is outside British Columbia:
(i) Registered office address in British Columbia,
(ii) Or address for service in British Columbia,
(iii) Registered office telephone number,
(iv) Registered office fax number,
(v) E-mail address for service,
(ii) Or address for service in British Columbia,
(iii) Registered office telephone number,
(iv) Registered office fax number,
(v) E-mail address for service,
(d) For each other office located in British Columbia, provide:
(i) Address,
(ii) General telephone number,
(iii) General fax number,
(iv) General e-mail address (if applicable),
(v) Website address (if different from that of head office),
(ii) General telephone number,
(iii) General fax number,
(iv) General e-mail address (if applicable),
(v) Website address (if different from that of head office),
2. Category
(a) _____ Investment dealer
(b) _____ Mutual fund dealer
(c) _____ Restricted dealer
(d) _____ Adviser
(e) _____ Publicly-offered equity securities
(f) _____ Privately-offered equity securities
(g) _____ Derivative securities
(h) _____ Debt (bonds and debentures)
(i) _____ Mutual fund units
(f) _____ Privately-offered equity securities
(g) _____ Derivative securities
(h) _____ Debt (bonds and debentures)
(i) _____ Mutual fund units
Attach, List of representatives and scope of authority for trading or advising.
3. Business History and Plans
It is important that we understand how your firm has evolved, who has been involved in that evolution, how your affiliates have evolved, and who has been involved with those evolutions. Respond to applicable questions and attach a copy of your current business plan:
(A) We have previously operated under other business names. _____
(B) Our affiliate(s) have previously operated under other business names. _____
For each of your previous business names and for each previous business name of your affiliates, provide:(B) Our affiliate(s) have previously operated under other business names. _____
(a) Name,
(b) Start and end date for using that business name,
(c) Registration status as a dealer or adviser (if any),
(d) List of partners, directors, officers, and significant securityholders,
4. Banking(b) Start and end date for using that business name,
(c) Registration status as a dealer or adviser (if any),
(d) List of partners, directors, officers, and significant securityholders,
For each account you maintain at any savings institution, provide:
(a) Name of savings institution,
(b) Address of the office, branch, or agency at which the account is kept,
(c) Account type and number,
(d) General phone number of the office, branch, or agency,
(b) Address of the office, branch, or agency at which the account is kept,
(c) Account type and number,
(d) General phone number of the office, branch, or agency,
5. Financial statements
(a) Financial year-end,
(b)Attach audited annual financial statements (Rules, sections 24 and 26)
(c)Attach interim financial statements (Rules, sections 25 and 26)
(b)Attach audited annual financial statements (Rules, sections 24 and 26)
(c)Attach interim financial statements (Rules, sections 25 and 26)
6. Capital sufficiency, calculation, and capital suppliers
(a) Attach your report disclosing the amount of capital reasonably sufficient to meet your expected business obligations and the related capital calculation (Rules, section 22)
(b) For each significant securityholder, provide:
(i) Name,
(ii) Percentage of ownership,
(ii) Percentage of ownership,
(c) For each guarantor of your financial obligations, provide:
(i) Name,
(ii) Address,
(iii) Phone number,
(iv) Description of guarantee,
(v) Term of guarantee,
(ii) Address,
(iii) Phone number,
(iv) Description of guarantee,
(v) Term of guarantee,
(d) For each loan made to your business by a partner, director,officer, or significant securityholder, or an associate of one of them, provide:
(i) Name of lender,
(ii) Amount and terms of loan,
(iii) Confirm the lender has agreed to be subordinated to the claims of your general creditors and your clients (Rules, section 40),
(i) Name of lender,
(ii) Amount and terms of loan,
(iii) Confirm the lender has agreed to be subordinated to the claims of your general creditors and your clients (Rules, section 40),
7. Bonding
(a) Attach your report disclosing the terms and amount of bonding coverage reasonably sufficient to cover the risk of client losses as a result of forgery, fraud, robbery, or theft by you or your representatives,
(b) For each bond you currently maintain, provide:
(i) Name of bond provider,
(ii) Address,
(iii) General phone number,
(iv) Describe the coverage,
(v) Term (duration) of bond,
(ii) Address,
(iii) General phone number,
(iv) Describe the coverage,
(v) Term (duration) of bond,
8. Regulatory and other history
(a) Regulatory history
Have you, or have any of your affiliates ever been:
(i) registered or licensed in any capacity anywhere else to trade in or advise on securities? For each such license or registration, provide:
(A) Name of regulator that provided the license or registration,
(B) Nature of license or registration,
(C) Jurisdiction of regulator (state, province, territory),
(ii) registered or licensed in any other capacity anywhere to deal with the public? (e.g. as an insurance agent, real estate agent, private investigator, mortgage broker, etc.). For each such license or registration, provide:(B) Nature of license or registration,
(C) Jurisdiction of regulator (state, province, territory),
(A) Name of regulator that provided the license or registration,
(B) Nature of license or registration,
(C) Jurisdiction of regulator (state, province, territory),
(B) Nature of license or registration,
(C) Jurisdiction of regulator (state, province, territory),
(iii) a regulated person of any marketplace, self regulatory organization, or regulatory organization in any jurisdiction? For each such situation, provide:
(A) Name of marketplace, self regulatory organization, or regulatory organization,
(B) Start and end date of membership, participation, or access rights,
(C) Jurisdiction,
(B) Start and end date of membership, participation, or access rights,
(C) Jurisdiction,
(iv) refused an application mentioned in 8(a)(i), (ii), or (iii) above, or been suspended or cancelled?
(b)Discipline history(A) If so, provide date and reasons,
Have you, or have any of your affiliates ever been disciplined by any of the regulatory organizations mentioned in (a), above? If so, provide:(i) Name of regulatory organization that administered the discipline,(ii) Date,(iii) Reasons,(iv) Description of discipline,
(c) Criminal history
Have you, or have any of your affiliates ever been convicted of a criminal or quasi-criminal offence? If so, provide:
(i) Name of person convicted,
(ii) Charge,
(iii) Date of conviction,
(iv) Sentence,
Is there a currently outstanding charge or indictment against you or against any of your affiliates? If so, provide:
(v) Name of person charged or indicted,
(vi) Description of charge,
(vii) Date set for next appearance in court, and nature of that appearance,
(viii) Court registry name and location,
(d) Civil proceedings
Have you or any of your affiliates ever been a defendant or respondent in proceedings alleging fraud, theft, deceit, misrepresentation, or similar conduct in any civil court in any jurisdiction? If so, provide:
(i) Name of case,
(ii) Name and location of court registry in which case was heard,
(iii) Outcome of case, whether settled, tried, or appealed,
(e) Solvency
Have you or any of your affiliates ever declared bankruptcy, made a voluntary assignment in bankruptcy, or been petitioned into bankruptcy? If so, provide:
(i) Name of bankruptcy trustee,
(ii) Address of trustee,
(iii) General phone number,
(iv) Start and end date of bankruptcy proceeding,
(v) Description of terms of discharge,
Have you or any of your affiliates ever had a receiver or receiver-manager appointed to hold your assets? If so, provide:
(vi) Name of receiver or receiver manager,
(vii) Address of receiver or receiver manager,
(viii) General phone number,
(ix) Start and end date of receivership,
(x) Description of terms completion of receivership,
9. Partners, directors, officers, significant securityholders
For each partner, director, officer, and significant securityholder, confirm you have filed a Personal Information Form (Rules, section 36; Form 31-902F).
10. Compliance systems (Code, sections 19 through 24)
Attach a description of your compliance system, including:
- Your policies and procedures,
- Supervision of representativesand other key personnel,
- Technical competence, resources, and experience,
- Your hiring system, including suitability and proficiency of representatives,
- Management of conflicts of interest (including how you separate analyst and underwriting functions from the rest of your business (if applicable)),
- Systems for safeguarding client funds and assets, and segregating them from your own,
- Recordkeeping systems,
- Management of client confidentiality, client communications (including disclosure), and client complaints,
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Name of authorized signatory
It is an offence under theSecurities Actto file an application containing a statement that is a misrepresentation or to provide information to the British Columbia Securities Commission that is false or misleading.