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CITY OF SANTA ANA <br />FINANCE & MANAGEMENT SERVICES AGENCY <br />BROKER / DEALER QUESTIONNAIRE AND CERTIFICATION <br />1.Name of Firm: <br />2.Address: (Local) <br />(Headquarters) <br />3.Telephone No.(Toll Free) <br />(Direct #) <br />4.Primary RepresentativeManager / Partner-in-Charge <br />NameName <br />TitleTitle <br />Telephone No.Telephone No. <br />Fax No.Fax No. <br />EmailEmail <br />No. of Years in Institutional Sales:No. of Years in Institutional Sales: <br />SEC Licenses:SEC Licenses: <br />5.Are you a Primary Dealer in U.S. Government Securities?............................................( ) Yes ( ) No <br />6.Are you a Regional Dealer in U.S. Government Securities?..........................................( ) Yes ( ) No <br />7.Are you a Broker - i.e., You DO NOTown positions of securities?................................( ) Yes ( ) No <br />8.Are you NASD certified and licensed to sell to California municipalities?......................( ) Yes ( ) No <br />9.What is the net capitalization of your firm? <br />10.What is the date of your firm’s fiscal year end? <br />11.Is your firm owned by a holding company? If so, what is the name and net capitalization of the holding firm? <br />12.Please provide your normal custody and delivery process: <br />*´«¸ ΐǾ ΑΏΐ9- <br />C¨³¸ ®¥ 3 ­³  A­­´ « <br />0 ¦¤ M <br />3³ ³¤¬¤­³ ®¥ )­µ¤²³¬¤­³ 0®«¨¢¸*´­¤ ΒΏǾ ΑΏΑΏ <br /> <br />