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Addendum To Vermont Branch Office Form. This is a Vermont form and can be use in Blue Sky Secretary Of State.
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Tags: Addendum To Vermont Branch Office Form, VT2, Vermont Secretary Of State, Blue Sky
ADDENDUM TO INVESTMENT ADVISER AND FEDERAL COVERED INVESTMENT ADVISER
VERMONT BRANCH OFFICE FORM (Form VT-2)
This addendum must be completed for each branch office which will be owned, leased or rented by any person other
than the firm filing a branch office form; or for any branch office which will conduct business under a name other
than that of the firm filing a branch office form.
1.
Name of investment adviser or federal covered investment adviser (same as item 1 on Form VT-1):
_____________________________________________________________________________________
2.
Will business be conducted at this branch office under any name other than that of the above-named firm?
_____ NO
_____ YES
If “Yes,” provide the name(s) under which business will be conducted at this location:
_____________________________________________________________________________________
3.
What types of businesses or services will be offered at this office? Check all that apply.
_____ Insurance
_____ Investment Advice
_____ Law Office
_____ Accounting Services
_____ Financial Planning
_____ Tax Advice
_____ Securities
_____ Banking (Specify bank): ______________________________
_____ Other - please describe with specificity: _______________________________________________
4.
Is there any agreement or contract between the above-named applicant and any person concerning the
operations at this office? _____ NO
_____ YES
If "YES", attach a copy of the agreement to this form. (not required for renewals)
5.
What person(s) are responsible, directly or indirectly, for paying the expenses of this office? Please provide
name, CRD number, address, and phone number for each:
_____________________________________________________________________________________
_____________________________________________________________________________________
6.
This office will be:
_____ owned
_____ leased
_____ rented
for purposes of conducing an investment advisory business. If this property will be owned, leased or rented
by someone other than the investment advisor or federal covered investment adviser, attach a list with the
name(s), address(es) and phone number(s) of the person(s) owning, leasing or renting such property. If
owned, leased or rented by a corporation or partnership, attach the names, titles, addresses, and phone
numbers of all officers, directors, and owners of such corporation or partnership.
Revised 10/18/06 VT Branch Office Form
American LegalNet, Inc.
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7.
By executing this form, the undersigned, in his or her individual capacity and on behalf of the above-named
applicant firm hereby swears and affirms that all information on this form and all materials filed in
connection with it are true, correct and complete. The undersigned stipulates, recites, acknowledges and
agrees that if the Vermont Securities Division finds that any information contained in this application or in
an amendment to this application is false, such finding shall constitute a violation of 9 V.S.A. § 5505.
Signed: _________________________________________________
Officer, Partner or Sole Proprietor of Applicant Firm
Date: _______________________
_______________________________________________________________________________
Typed Name and Title of Signatory
Revised 10/18/06 VT Branch Office Form
American LegalNet, Inc.
www.FormsWorkflow.com