Broker Dealer Affidavit Form. This is a New Mexico form and can be use in Securities Statewide.
Tags: Broker Dealer Affidavit, New Mexico Statewide, Securities
COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : (Rev. 11/98) Calendar No. : JUDICIAL SUBPOENA Plaintiff(s) BROKER-DEALER AFFIDAVIT STATE OF NEW MEXICO -against: I, the undersigned, ___________________________________________, being first duly sworn, : upon oath state: : I am an official of the broker-dealer firm of ______________________________ (hereinafter “Broker-dealer”) and, as such, authorized to make this affidavit on behalf of Broker-dealer. Defendant(s) : ...................................................... I am familiar with Section 58-13B-11D of the New Mexico Securities Act of 1986 (the “Act”), which prohibits dual licensing of sales representatives, and Rule 12 NMAC 126.96.36.199.1, which defines “branch offices” to include any place of business in the State of New Mexico of one or more licensed agents. THE PEOPLE OF THE will comply with all provisions of the Act and the Rules thereunder, including the Broker-dealer STATE OF NEW YORK provisions cited in the previous paragraph. TO I have executed this Affidavit in behalf of Broker-dealer after having read and understanding the contents hereof. I hereby represent that all information contained herein is true, current and complete, to the best GREETINGS: of my knowledge and belief. WE COMMAND day of ________________________, _________. you and each of you attend before Dated this _____ YOU, that all business and excuses being laid aside, , the Honorable at the Court located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a_____________________________________________ witness in this action on the part of the (Print Broker-dealer Name) By: _________________________________________ (Signature of Authorized Official) 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 Title: ________________________________________ result of your failure to comply. Witness, Honorable Court in County, , one of the Justices of the day of , 20 ACKNOWLEDGMENT STATE OF ____________________________ ) ) ss. COUNTY OF __________________________ ) (Attorney must sign above and type name below) On this _____ day of ____________________, _______, before me personally appeared Attorney(s) for _______________________, to me known to be the person described in and who executed the foregoing instrument and acknowledged to me that he/she executed the same as his/her free act and deed. (Notarial seal) My Commission expires: _________________________ ______________________________________ Notary Public P.O. Address Office and Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com