Forms

PURPOSE: This rule prescribes the forms adopted and approved for filing with the commissioner. PUBLISHER’S NOTE: The secretary of state has determined that the publication of the entire text of the material which is incorporated by reference as a portion of this rule would be unduly cumbersome or expensive. This material as incorporated by reference in this rule shall be maintained by the agency at its headquarters and shall be made available to the public for inspection and copying at no more than the actual cost of reproduction. This note applies only to the reference material. The entire text of the rule is printed here. (1) The following forms have been adopted and approved for filing with the Securities Division: (A) Broker-Dealers, Agents, Investment Advisers, and Investment Adviser Representatives— 1. Form BD—Uniform Application for Broker-Dealer Registration approved May 2001, OMB Approval Number 32350012, or any form which substantially comports with the specified form; 2. Form BDW—Uniform Request for Broker-Dealer Withdrawal approved November 2000, OMB Approval Number 3235-0018, or any form which substantially comports with the specified form; 3. Form SBD-1—Missouri Broker-Dealer Affidavit revised January 2005, or any form which substantially comports with the specified form; 4. Form X-17A-5—Financial and Operational Combined Uniform Single Report approved July 2002, OMB Approval Number 3235-0123, or any form which substantially comports with the specified form; 5. Form U-4—Uniform Application for Securities Industry Registration or Transfer adopted by the North American Securities Administrators Association, Inc. (NASAA) on April 16, 2003, or any form which substantially comports with the specified form; 6. Form U-5—Uniform Termination Notice for Securities Industry Registration adopted by the NASAA on April 16, 2003, or any form which substantially comports with the specified form; 7. Form SA-1—Missouri Application for Renewal Registration as Agent revised August 2003, or any form which substantially comports with the specified form; 8. Form ADV—Uniform Application for Investment Adviser Registration approved July 2003, OMB Approval Number 32350049, or any form which substantially comports with the specified form; 9. Form ADV-W—Uniform Notice of Withdrawal from Registration as Investment Adviser approved January 2001, OMB Approval Number 3235-0313, or any form which substantially comports with the specified form; 10. Form SADV-1—State Covered Investment Adviser Affidavit revised March 2002, or any form which substantially comports with the specified form; 11. Form SADV-SH—State Application for Hardship Exemption from IARD revised October 2001, or any form which substantially comports with the specified form; and 12. Form U-2—Uniform Consent to Service of Process adopted by NASAA and revised November 1997, or any form which substantially comports with the specified form. (B) Registration of Securities— 1. Form U-1—Uniform Application to Register Securities adopted by NASAA and revised February 1997, or any form which substantially comports with the specified form; 2. Form SR-1—Form of Prospectus for Registration of Securities by Qualification revised August 2003; 3. Form U-2—Uniform Consent to Service of Process adopted by NASAA and revised November 1997, or any form which substantially comports with the specified form; 4. Form U-2A—Uniform Form of Corporate Resolution adopted by NASAA and revised April 1998, or any form which substantially comports with the specified form; 5. Form SR-2—Missouri Annual Report for Renewal of Registration of Securities revised December 2001; 6. Form SR-3—Midwest Regional Review Application revised July 2003, or any form which substantially comports with the specified form; 7. Form SR-4—Missouri Impoundment of Funds Agreement revised September 2002, or any form which substantially comports with the specified form; 8. Form SR-5—Missouri Application for Registration of Single Family Mortgage Revenue Bonds revised June 2002, or any form which substantially comports with the specified form; and 9. Form U-7—Small Company Offering Registration (SCOR) Form adopted by NASAA and revised September 1999, or any form which substantially comports with the specified form. (C) Exemptions from Registration, Exceptions from Definition, Federal Covered Securities— 1. Form SE-1—Statement of Claim for the Exemption of Securities of a New Generation Processing Entity revised August 2003; 2. Form SE-2—Statement of Claim for the Exemption of a Securities of a Missouri Agricultural Cooperative revised December 2004; 3. Form NF—Uniform Investment Company Notice Filing adopted by NASAA April 1997, or any form which substantially comports with the specified form; 4. Form D—Notice of Sale of Securities Pursuant to Regulation D, Section 4(6), and/or Uniform Limited Offering Exemption approved in June 2002, OMB Approval Number 3235-0076, or any form which substantially comports with the specified form; and 5. Form AI—Notice of Sale of Securities Pursuant to the Missouri Accredited Investor Exemption, or any form which substantially comports with the specified form. (D) Commodities— 1. Form C-4—Missouri Commodity Broker-Dealer, Sales Representative, Statutory Bond, revised June 2001, or any form which substantially comports with the specified form; and 2. Form C-16—Missouri Application for Renewal Registration of Sales Representative revised June 2001, or any form which substantially comports with the specified form. (2) The Securities Division on request will supply the forms listed in 15 CSR 30-50.040(1) in printed format, which are incorporated by reference herein, as published by the Securities Division, 600 W. Main Street, PO Box 1276, Jefferson City, MO 65102. This rule does not incorporate any subsequent amendments or additions. Accurate reproduction of the forms may be utilized for filing in lieu of the printed forms. All uniform forms are electronically available at http://www.sos.mo.gov/securities. AUTHORITY: section 409.6-605, RSMo Supp. 2013.* Original rule filed June 25, 1968, effective Aug. 1, 1968. Amended: Filed May 21, 1969, effective Aug. 1, 1969. Amended: Filed July 21, 1972, effective Aug. 1, 1972. Amended: Filed June 3, 1974, effective June 17, 1974. Amended: Filed Nov. 15, 1974, effective Nov. 25, 1974. Amended: Filed Dec. 19, 1975, effective Dec. 31, 1975. Emergency amendment filed Aug. 11, 1978, effective Aug. 23, 1978, expired Dec. 21, 1978. Amended: Filed Aug. 11, 1978, effective Feb. 11, 1979. Emergency amendment filed Aug. 1, 1980, effective Aug. 13, 1980, expired Dec. 11, 1980. Amended: Filed Aug. 13, 1980, effective Dec. 11, 1980. Amended: Filed Oct. 16, 1986, effective Feb. 12, 1987. Rescinded and readopted: Filed Sept. 29, 1988, effective Nov. 11, 1988. Rescinded and readopted: Filed March 27, 1989, effective June 12, 1989. Amended: Filed Feb. 2, 1996, effective July 30, 1996. Rescinded and readopted: Filed Dec. 17, 2001, effective July 30, 2002. Emergency amendment filed Aug. 29, 2003, effective Sept. 12, 2003, expired March 9, 2004. Amended: Filed Aug. 29, 2003, effective Feb. 29, 2004. Amended: Filed May 26, 2004, effective Nov. 30, 2004. Amended: Filed Dec. 10, 2004, effective June 30, 2005. Amended: Filed March 3, 2006, effective Sept. 30, 2006. Amended: Filed Dec. 3, 2013, effective July 30, 2014. *Original authority: 409.6-605, RSMo 2003.