REQUIREMENTS FOR BROKER-DEALER REGISTRATION I. FILING REQUIREMENTS - CRD A. Broker-Dealer applications are filed with the CRD. Filing fee of $250.00 is FILING REQUIREMENTS 226 STATE A. Please complete the attached cover sheet and return it to the Indiana E. Indiana has 30 days to review your completed application for registration by Indiana. American LegalNet, Inc. www.FormsWorkFlow.com III. REQUIRED EXAMS : BROKER-DEALER PRINCIPALS AND BRANCH MANAGERS (General): o FINRA Series 4, 9 and 10 BROKER-DEALER PRINCIPALS AND BRANCH MANAGERS (Restricted) (Firm restricted to business in subject area of examination): o FINRA Series 26 (Investment Company/Variable Contracts) o FINRA Series 39 (Direct Participation Programs) o FINRA Series 4 (Registered Options) BROKER-DEALER AGENTS (General): o FINRA Series 7 and FINRA Series 63 or 66. BROKER-DEALER AGENTS (Restricted): o FINRA Series 6 (Investment Company/Variable Contracts) o FINRA Series 22 (Direct Participation Programs) o FINRA Series 62 (Corporate Securities) o FINRA Series 79 (Limited Representative-Investment Banking) o AND FINRA Series 63 or 66 Questions regarding audited financials and FOCUS I and II contact Doreen Fuery, Senior Accountant, (317) 232-0737. Questions regarding branch offices or exams contact a Division Compliance Officer at (317) 232-6681. American LegalNet, Inc. www.FormsWorkFlow.com INDIANA BROKER-DEALER COVER SHEET This cover sheet should be completed in full and returned, along with the requested documents to the Indiana Securities Division so that your firm222s broker-dealer application may be processed. Please type all information. 1. Name of Firm: Contact Person: Address of Firm: Telephone # ( ) Fax # ( ) E-Mail CRD Number of Firm Have you filed with the CRD to request registration in Indiana? Have you filed with the CRD to request registration in Indiana for all agents you wish to register in Indiana? 2. Name of First Principal CRD # of First Principal Name of Second Principal CRD # of Second Principal 3. Does the firm intend on having a branch office or agent in Indiana? YES NO If YES, please attach a copy of the Certificate of Authority of a Foreign Corporation to Transact Business in Indiana. 4. What is the firm222s fiscal year end? American LegalNet, Inc. www.FormsWorkFlow.com PLEASE ATTACH THE FOLLOWING DOCUMENTS TO THIS COVER SHEET AND RETURN TO THE INDIANA SECURITIES DIVISION. The firm222s most recent audited financial statements. See NOTE below. The firm222s most recent FOCUS Report. If the firm222s most recent audited financial statements and FOCUS Report are over 60 days old, please include an unaudited balance sheet. If the firm intends on having a branch office or agent living in Indiana, please attach a copy of the Certificate of Authority of a Foreign Corporation to Transact Business in Indiana. NOTE: If the firm does not yet have audited financial statements and / or a FOCUS Report, please forward an unaudited balance sheet not older than 60 days. American LegalNet, Inc. www.FormsWorkFlow.com