REGISTERED SECURITIES PRINCIPAL
for a Non-FINRA firm

APPLICANT CERTIFICATION

I, ______________________________, CRD number  _____________, in connection with my application to register as a principal of _______________________________________________________________, hereby certify to the Administrator of the Oklahoma Department of Securities that:

  1. I have carefully reviewed the Oklahoma Uniform Securities Act of 2004, 71 O.S., 1-101 through 1-701, as well as the rules and regulations adopted thereto, and I fully understand my responsibilities there under as a registered principal, including but not limited to, my responsibility for the supervision of all agents of said broker-dealer who are registered in the State of Oklahoma; and
  2. All information concerning myself as filed on the Form U-4 with the Central Registration Depository (CRD) or as filed on the Form U-4 directly with the Administrator of the Oklahoma Department of Securities is true and correct and a correcting amendment shall be promptly filed when such information becomes inaccurate or incomplete in any material respect.
Dated this _____day of _____________. 20___.

______________________________________________

(Signature)

STATE OF.......................................................... )
) SS
COUNTY OF...................................................... )
Subscribed and sworn before me this _____ day of ____________, 20 ____.

_______________________________________

My Commission Expires:____________________

Notary Public

 MANAGEMENT CERTIFICATION 

I, _______________________________________, an officer, director, partner or sole proprietor of _____________________________________________________________________, hereby certify to the Administrator of the Oklahoma Department of Securities that the above applicant for registration as a principal has been provided adequate instruction with respect to his/her responsibilities under the Oklahoma Uniform Securities Act of 2004, and the rules and regulations.

Dated this _____day of _____________. 20___.

_____________________________________________

(Signature)

_____________________________________________

(Title)

STATE OF.......................................................... )
) SS
COUNTY OF...................................................... )
Subscribed and sworn before me this _____ day of ____________, 20 ____.

_______________________________________

My Commission Expires:____________________

Notary Public

OBD-02 6/2009