COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Mail to: State of California Department of Corporations 1515 K Street, Suite 200 -againstSacramento, CA 95814-4052 Index No. Calendar No. Fee: $300 : JUDICIAL SUBPOENA File No. ________________________ Plaintiff(s) : Date of Application _______________ : DEPARTMENT OF CORPORATIONS : STATE OF CALIFORNIA Defendant(s) : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .APPLICATION . . . . . . . . . . . . . . . . . . . . . . . . BY NOTIFICATION PURSUANT TO CORPORATIONS CODE SEC. 25211(b) FOR BROKER-DEALER CERTIFICATE THE PEOPLE OF THE STATEwith NEW YORK and Amendments to Applications for Broker-Dealer (Only for Use in Connection OF Applications Certificate Pursuant to Section 25211(b), Corporations Code (Application by Notification), and TO Section 260.241.4, Title 10, California Code of Regulations.) 1. Date of Notice: ______________________________________________________________________ 2. GREETINGS: Notice ( ) Original ( ) Amended Notice 3. Name of Broker-Dealer Address of Principal Office WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court ____________________________________________________________________________________ located at County of 4. inName and address of officer or partner of the broker-dealer who o'clock in the compliance and any recessed is to receive room , on the day of , 20 , at noon, and at orinformation communicationsgive evidence as a witness in this is responsible forof the adjourned date, to testify and from the Department and who action on the part disseminating the same within the broker-dealer's organization. Name _______________________________________ Title _________________________________ Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to Address _____________________________________ Telephone ( ______________________ the party on whose behalf this subpoena was issued for a maximum penalty) of $50 and all damages sustained as a result of your failure to comply. _____________________________________________ (See Corporations Code Section 25245) Witness, Honorable , one of the Justices of the 5. Court in The following representations are made to the Commissioner of Corporations by the brokerCounty, day of , 20 dealer: a) The broker-dealer has a currently effective registration as a broker-dealer under the Securities Exchange Act of 1934 (15 USC 78a et seq.). (Attorney must sign above and type name below) b) The broker-dealer is a member in good standing of the self-regulatory organizations checked: ( ) NYSE ( ) AMEX ( ) PCX ) Attorney(s)( for NASD c) Check the applicable box: ( ) (1) The broker-dealer has never had a certificate as a broker-dealer, investment adviser or agent revoked, or an application for such a certificate denied, under the Corporate Office and P.O. Address Securities Law of 1968 or any predecessor statute. ( ) (2) The Commissioner has by order waived the denial or revocation of a certificate as a Telephone to the broker-dealer, investment adviser or agent heretofore issuedNo.: broker-dealer. Facsimile No.: E-Mail Address: Mobile Tel. No.: 260.211.1 (Rev 04/03) American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Calendar No. : JUDICIAL SUBPOENA 6. Exhibits. Attach the following exhibits: Plaintiff(s) a. Attach a completed Customer Authorization of Disclosure of Financial Records (Form QR 500.261 (01/00), hereby incorporated by reference). -against: b. Attach a completed Form BD (Uniform Application for Broker-Dealer Registration (17 CFR : 249.501) and the Schedules thereto. : NOTE: Social Security Numbers: In accordance with Section 7 of the Privacy Act of 1974 (PL. 93-579), the following information is provided in connection with the disclosure of social security account numbers in Form BD (Uniform Application for Broker-Dealer Registration (17 CFR Defendant(s) Schedules thereto. 249.501) and the : ...................................................... Disclosure of a social security account number shall be considered a voluntary disclosure. except as provided below. A social security account number is solicited pursuant to one or more of the following authorities: Section 25211, Corporations Code. Section 260.21, Title 10, California Code of Regulations. THE PEOPLE OF THE STATE OF NEW YORK Section 17520, Family Code. Uses TO to be made of social security account numbers, solicited by Form BD and the Schedules thereto are: A. For all persons disclosing social security account numbers, the number may be used, in addition to other information provided, to conduct a background investigation of the individual by the Department of Justice's Identification and Information Branch or by other federal, state or local law enforcement agencies. The social security number may also be used to respond to requests for this information made by child support agencies. GREETINGS: B. The completed form, except any disclosed social security account numbers, shall become a public record and available to members of the public pursuant to the provisions of the Public Records Act (Government Code WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend Sections 6250 et seq.). before , the Honorable at the Court located at 7. Applicant's Minimum Net Capital Requirement: $_____________________________ County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed / or8. Applicant's Fiscal Year Ends:evidence as a (Month/Day) action on the part of the adjourned date, to testify and give witness in this 9. Execution: Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to ____________________________________ the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. By ____________________________________ Witness, Honorable Court in County, day of ____________________________________ the , one of the Justices of (Title) , 20 (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: 260.211.1 (Rev 04/03) American LegalNet, Inc. www.USCourtForms.com