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Form U6 (FOR CRD-IARD Organization) Form. This is a Official Federal Forms form and can be use in FINRA.
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Tags: Form U6 (FOR CRD-IARD Organization), U6, Official Federal Forms FINRA,
Rev. Form U6 (05/2009)
PRIMARY BUSINESS NAME:
BD NUMBER:
U6 - SUBJECT OF ACTION
ENTITY NAME:
CRD #:
CRD DBA NAME:
BUSINESS STREET ADDRESS LINE 1:
BUSINESS STREET ADDRESS LINE 2:
CITY:
COUNTRY:
STATE:
ZIP/POSTAL CODE:
LEGAL STATUS OF SUBJECT:
CORPORATION
SOLE PROPRIETORSHIP
PARTNERSHIP
LIMITED LIABILITY COMPANY
STATE OF FORMATION:
COUNTRY OF FORMATION:
OTHER (SPECIFY)________________________
DATE OF FORMATION (MM/DD/YYYY):
IARD PRIMARY BUSINESS NAME:
BUSINESS STREET ADDRESS LINE 1:
BUSINESS STREET ADDRESS LINE 2:
CITY:
COUNTRY:
STATE:
ZIP/POSTAL CODE:
IARD LEGAL STATUS OF SUBJECT:
CORPORATION
SOLE PROPRIETORSHIP
PARTNERSHIP
LIMITED LIABILITY PARTNERSHIP (LLP)
LIMITED LIABILITY COMPANY (LLC)
OTHER (SPECIFY)_________________________
STATE OF FORMATION:
REGULATOR CONTACT:
COUNTRY OF FORMATION:
DATE OF FORMATION (MM/DD/YYYY):
REGULATOR PHONE NUMBER:
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Rev. Form U6 (05/2009)
PRIMARY BUSINESS NAME:
BD NUMBER:
DISCLOSURE REPORTING PAGES
Rev. DRP (06/2003)
U6 - BANKRUPTCY/SIPC/COMPROMISE WITH CREDITORS DRP
This Disclosure Reporting Page is an INITIAL or AMENDED
IARD SEC Only
IA Disclosure Expiration Date: ________________________
1.
Action Type: [Circle one: Bankruptcy, Compromise, Declaration, Liquidated, Other, Receivership]
2.
Action Date (MM/DD/YYYY): ___________________
If not exact, provide explanation:
3.
If the financial action relates to an organization over which you exercise(d) control, enter Organization Name and
your position, title or relationship:
Was the Organization investment-related?
Yes
Exact
Explanation
No
4.
Court (Name of Federal, State or Foreign Court), Location of Court (City or County and State or Country),
Docket/Case Number and Bankruptcy Chapter Number (if Federal Bankruptcy Filing):
5.
Is action currently pending?
6.
If not pending, provide disposition type: [Circle one: Direct Payment Procedure, Discharged, Dismissed, Dissolved, Other,
SIPA Trustee Appointed, Satisfied/Released]
7.
Disposition Date (MM/DD/YYYY): __________________
If not exact, provide explanation:
8.
Provide a brief summary of events leading to the action and if not discharged, explain. (The information must fit within
the space provided.):
9.
If a SIPA trustee was appointed or a direct payment procedure was begun, enter the amount paid or agreed to be
paid by the subject; or the name of the trustee:
Yes
No
Exact
Explanation
Yes
No
Currently Open?
Date Direct Payment Initiated/Filed or Trustee Appointed (MM/DD/YYYY): _______________
Exact
Explanation
If not exact, provide explanation:
10. Comment (Optional). You may use this field to provide a brief summary of the circumstances leading to the action as
well as the current status or final disposition. Include the details as to creditors, terms, conditions, amounts due and
settlement schedule (if applicable). Your information must fit within the space provided.
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Rev. Form U6 (05/2009)
PRIMARY BUSINESS NAME:
BD NUMBER:
Rev. DRP (06/2003)
U6 - CIVIL JUDICIAL DRP
This Disclosure Reporting Page is an INITIAL or AMENDED
One event may result in more than one affirmative answer to the above items. Use only one DRP to report details related
to the same event. Unrelated civil judicial actions must be reported on separate DRPs.
IARD SEC Only
IA Disclosure Expiration Date: ________________________
1.
Court Action initiated by: (Name of regulator, foreign financial regulatory authority, SRO, commodities exchange, Agency,
Firm, Private Plaintiff, etc.)
2.
Principal Relief Sought: [Circle one: Cease and Desist, Civil Penalty(ies)/Fine(s), Disgorgement, Injunction, Money Damages
(Private/Civil Complaint), Other, Restitution, Restraining Order]
Other Relief Sought:
Exact
Explanation
3.
Filing Date of Court Action (MM/DD/YYYY): ____________________
If not exact, provide explanation:
4.
Principal Product Type: [Circle one: Annuity(ies) - Fixed, Annuity(ies) - Variable, Banking Products (Other than CD(s)), CD(s),
Commodity Options(s), Debt - Asset Backed, Debt - Corporate, Debt - Government, Debt - Municipal, Derivative(s), Direct
Investment(s) - DPP & LP Interest(s), Equity - OTC, Equity Listed (Common & Preferred Stock), Futures - Commodity, Futures Financial, Index Options(s), Insurance, Investment Contract(s), Money Market Fund(s), Mutual Fund(s), No Product, Options,
Other, Penny Stock(s), Unit Investment Trust(s)]
Other Product Types:
5.
Formal Action was brought in (include name of Federal, Military, State or Foreign Court, Location of Court - City or
County and State or Country, Docket/Case Number):
6.
Employing Firm when activity occurred which led to the civil judicial action:
7.
Describe the allegations related to this civil action. (The information must fit within the space provided.):
8.
Current Status?
9.
If on appeal, action appealed to (provide name of court):
Pending
On Appeal
Final
Date Appeal Filed (MM/DD/YYYY): ______________
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Rev. Form U6 (05/2009)
PRIMARY BUSINESS NAME:
BD NUMBER:
U6 - CIVIL JUDICIAL DRP (CONTINUED)
10. If pending, date notice/process was served (MM/DD/YYYY): __________________
If not exact, provide explanation:
Rev. DRP (06/2003)
Exact
Explanation
If Final or On Appeal, complete all items below. For Pending Actions, complete Item 14 only.
11. How was matter resolved: [Circle one: Consent, Dismissed, Judgment Rendered, Opinion, Other, Settled, Withdrawn]
12. Resolution Date (MM/DD/YYYY): ____________________
If not exact, provide explanation:
Exact
Explanation
13. Resolution Detail:
A. Were any of the following Sanctions Ordered? (Check all appropriate items):
Monetary/Fine Amount: $_____________
Disgorgement/Restitution
Cease and Desist/Injunction
Suspension
Revocation/Expulsion/Denial
Censure
Bar
B. Other Sanctions:
C. Sanction detail: if suspended, enjoined or barred, provide duration including start date and capacities affected
(General Securities Principal, Financial Operations Principal, etc.). If requalification by exam/retraining was a
condition of the sanction, provide length of time given to requalify/retrain, type of exam required and whether
condition has been satisfied. If disposition resulted in a fine, penalty, restitution, disgorgement or monetary
compensation, provide total amount, portion levied against broker, date paid and if any portion of penalty was
waived:
14. Comment (Optional). You may use this field to provide a brief summary of the circumstances leading to the action, as
well as the current status or final disposition and/or finding(s). Include the number of investors in the reporting
jurisdiction, the total number of investors in the program, the amount invested in the reporting jurisdiction and the total
amount invested. Your information must fit within the space provided.
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Rev. Form U6 (05/2009)
PRIMARY BUSINESS NAME:
BD NUMBER:
U6 - CRIMINAL DRP
Rev. DRP (06/2003)
This Disclosure Reporting Page is an INITIAL or AMENDED
IARD SEC Only
IA Disclosure Expiration Date: ________________________
1.
If charge(s) were brought against an organization over which the subject exercise(d) control: (Enter Organization Name,
whether or not the organization was an investment-related business and the subject's position, title or relationship.)
2.
Formal Charge(s) were brought in: (include name of Federal, Military, State or Foreign Court, Location of Court - City or
County and State or Country, Docket/Case number).
3.
Event Disclosure Detail (Use this for both organizational and individual charges.)
A. Date First Charged (MM/DD/YYYY):______________
If not exact, provide explanation:
Exact
Explanation
B. Event Disclosure Detail (include Charge(s)/Charge Description(s), and for each charge provide: 1. number
of counts, 2. felony or misdemeanor, 3. plea for each charge, and 4. product type if charge is
investment-related):
C. Did any of the Charge(s) within the Event involve a Felony?
D. Current status of the Event?
Pending
Yes
On Appeal
No
Final
E. Event Status Date (complete unless status is Pending) (MM/DD/YYYY): _____________
If not exact, provide explanation:
Exact
Explanation
4.
Disposition Disclosure Detail Include for each charge, A. Disposition type [e.g., convicted, acquitted, dismissed,
pretrial, etc.], B. Date, C. Sentence/Penalty, D. Duration [if sentence-suspension, probation, etc.], E. Start Date of
Penalty, F. Penalty/Fine Amount and G. Date Paid.
5.
Comment (Optional). You may use this field to provide a brief summary of the circumstances leading to the charge(s) as
well as the current status or final disposition. Include the relevant dates when the conduct that was the subject of the
charge(s) occurred. Include the number of investors in the reporting jurisdiction, the total number of investors in the
program, the amount invested in the reporting jurisdiction, the total amount invested and whether the action is based on a
referral or investigation from your securities division. Your information must fit within the space provided.
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Rev. Form U6 (05/2009)
PRIMARY BUSINESS NAME:
BD NUMBER:
Rev. DRP (06/2003)
U6 - REGULATORY ACTION DRP
This Disclosure Reporting Page is an INITIAL or AMENDED
IARD SEC Only
IA Disclosure Expiration Date: ________________________
1.
Regulatory Action initiated by:
Federal Banking Agency
SEC
Other
State
SRO
National Credit Union Administration
Foreign
Other
Full name of regulator (if other than the SEC) that initiated the action:
2.
Principal Sanction/Relief Sought: [Circle one: Bar, Cease and Desist, Censure, Civil and Administrative
Penalty(ies)/Fine(s), Denial, Disgorgement, Expulsion, Injunction, Other, Prohibition, Reprimand, Restitution, Revocation,
Suspension, Undertaking]
Other Sanctions/Relief Sought:
Exact
Explanation
3.
Date Initiated (MM/DD/YYYY): ______________
If not exact, provide explanation:
4.
Docket/Case Number: ________________________________
5.
Employing Firm when activity occurred which led to the regulatory action: ________________________________
6.
Principal Product Type: [Circle one: Annuity(ies) - Fixed, Annuity(ies) - Variable, Banking Products (Other than CD(s)), CD(s),
Commodity Options(s), Debt - Asset Backed, Debt - Corporate, Debt - Government, Debt - Municipal, Derivative(s), Direct
Investment(s) - DPP & LP Interest(s), Equity - OTC, Equity Listed (Common & Preferred Stock), Futures - Commodity, Futures Financial, Index Options(s), Insurance, Investment Contract(s), Money Market Fund(s), Mutual Fund(s), No Product, Options,
Other, Penny Stock(s), Unit Investment Trust(s)]
Other Product Types:
7.
Describe the allegations related to this regulatory action. (The information must fit within the space provided.):
8.
Current Status?
9.
If on appeal, regulatory action appealed to: (SEC, SRO, Federal or State Court) and Date Appeal Filed:
Pending
On Appeal
Final
If Final or On Appeal, complete all items below. For Pending Actions, complete Item 14 only.
10. How was matter resolved: [Circle one: Acceptance, Waiver & Consent (AWC); Consent; Decision; Decision & Order of Offer of
Settlement; Dismissed; Order; Other; Settled; Stipulation and Consent; Vacated; Wtihdrawn]
11. Does the order constitute a final order based on violations of any laws or regulations that prohibit fraudulent,
Yes
No
manipulative, or deceptive conduct?
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Rev. Form U6 (05/2009)
PRIMARY BUSINESS NAME:
BD NUMBER:
U6 - REGULATORY ACTION DRP (CONTINUED)
12. Resolution Date (MM/DD/YYYY): _____________________
If not exact, provide explanation:
Exact
Rev. DRP (06/2003)
Explanation
13. Resolution Detail:
A. Were any of the following Sanctions Ordered? (Check all appropriate items):
Monetary/Fine Amount: $_____________
Disgorgement/Restitution
Cease and Desist/Injunction
Suspension
Revocation/Expulsion/Denial
Censure
Bar
B. Other Sanctions Ordered:
C. Sanction detail: if suspended, enjoined or barred, provide duration including start date and capacities affected
(General Securities Principal, Financial Operations Principal, etc.). If requalification by exam/retraining was a
condition of the sanction, provide length of time given to requalify/retrain, type of exam required and whether
condition has been satisfied. If disposition resulted in a fine, penalty, restitution, disgorgement or monetary
compensation, provide total amount, portion levied against the subject, date paid and if any portion of penalty was
waived:
14. Comment (Optional). You may use this field to provide a brief summary of the circumstances leading to the action as
well as the current status or final disposition and/or finding(s). Include relevant terms, conditions and dates. Include the
number of investors in the reporting jurisdiction, the total number of investors in the program, the amount invested in the
reporting jurisdiction, the total amount invested and whether the action is based on a referral or investigation from your
securities division. Your information must fit within the space provided.
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