§551.32(1)(b), Wis. Stats. and 5.01(2), Wis. Adm. Code COURT COUNTY . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . .STATE. OF. WISCONSIN. . ..... .. .......... : Index DEPARTMENT OF FINANCIAL INSTITUTIONS No. DIVISION OF SECURITIES : Plaintiff(s) -against- : : Calendar No. th 345 West Washington Ave., 4 Fl. PO Box 1768 JUDICIAL SUBPOENA Madison, WI 53701-1768 (608) 266-3693 TTY: (608) 266-8818 Internet: www.wdfi.org : INVESTMENT ADVISER DESIGNATION OF SUPERVISOR : Pursuant to s. DFI-Sec 5.07(7), Wis. Adm. Code, every licensed investment adviser shall employ at its principal Defendant(s) office or designated office of supervision in accordance with s. DFI-Sec 5.03(1), Wis. Adm. Code, at least one : ..... ....... . ..... . .. ......... . .. . ........ person .designated. in. writing .to .the .administrator. to. act .in .a. supervisory. capacity who is licensed as an investment adviser representative in this state and has satisfied the examination requirement in s. DFI-Sec 5.01(5). FIRM INFORMATION THE PEOPLE OF THE STATE OF NEW YORK FIRM’S NAME: ______________________________________________________________________________ TO FIRM’S ADDRESS ___________________________________________________________________________ ___________________________________________________________________________ GREETINGS: DESIGNATED SUPERVISOR INFORMATION WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before If the firm wishes to designate more than one supervisor, at the one form for each supervisor designated. submit the Honorable Court , located at County of NAME OF DESIGNATED SUPERVISOR: _________________________________________________________ in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date,OF DESIGNATED SUPERVISOR: witness in this action on the part of the to testify and give evidence as a HOME ADDRESS ____________________________________________ ____________________________________________ Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to ADDRESS OF OFFICE OF EMPLOYMENT: ___________________________________________________ the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a (Must be Principal or Designated Office) result of your failure to comply. ___________________________________________________ Witness, Honorable , one of the Justices DATE QUALIFIED/PENDING IN WISCONSIN: __________________________________________ of the Court in County, day of , 20 THIS FORM IS TO BE SIGNED BY ANY OFFICER OF THE FIRM (Attorney must sign above and type name below) ___________________________________________________________________________________ TYPED NAME AND TITLE OF SIGNATORY _________________________________________________ SIGNATURE Attorney(s) for ______________________________ DATE This Division is to be notified within 10 days of any change in designated supervisor. Failure to do so will be cause for a delinquent filing fee of $100 pursuant to s. DFI-Sec 7.01(7)(g), Wis.and P.O. Address Office Adm. Code. (Please refer to s. DFI 5.04(4), Wis. Adm. Code.) Telephone No.: This document can be made available in alternate formats upon request to qualifying Facsimile No.: individuals with disabilities. E-Mail Address: Mobile Tel. No.: DFI/DOS/IADS(WI)(R09/00) American LegalNet, Inc. www.USCourtForms.com