Form SEC 2900 SEC 2900 Form MA-NR

FORM MA-NR

OMB
 APPROVAL

OMB
 Number:

 3235-­‐0681

Expires:

 February
 28,
 2017

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DESIGNATION OF U.S. AGENT FOR SERVICE OF PROCESS FOR NON-RESIDENTS
Please read the General Instructions for this form and other forms in the MA series, as well as its subsection, “General
Instructions to Form MA-NR,” before completing this form. All italicized terms herein are defined or described in the
Glossary of Terms appended to the General Instructions.

Purpose: Each non-resident municipal advisor, non-resident general partner or non-resident managing
agent of a municipal advisor, and non-resident natural person who is a person associated with the municipal
advisor and engaged in municipal advisory activities on its behalf must execute a written irrevocable consent
and power of attorney on Form MA-NR to appoint an agent in the United States, upon whom may be served
any process, pleadings, or other papers in any action brought against such non-resident municipal advisor,
general partner, managing agent or natural person associated with the municipal advisor.

Instructions to Complete this Form:
1. This power of attorney, consent, stipulation, and agreement shall be signed and notarized by the
non-resident municipal advisor, non-resident general partner or managing agent, or non-resident
natural person who is a person associated with the municipal advisor and engaged in municipal
advisory activities on its behalf, as applicable, in Section A of Form MA-NR. The form must be
signed by the authorized agent for service of process in the United States in Section B of Form MA-NR.
2. The name of each person who signs this Form MA-NR must be typed or printed beneath the person’s
signature.
3. Any person who occupies more than one of the specified positions must indicate each capacity in
which the person is signing the form.
4. Section C Documentation: If any person signs this form pursuant to a written authorization – e.g., a
board resolution or power of attorney – an accurate and complete copy of each such document must be
included with the Form MA-NR.
5. Attachment to Form MA or Form MA-I:
a) Complete and execute a printed Form MA-NR, including signatures and notarization. Then
scan the original completed and executed form to create a PDF file. Please consult the instructions for uploading PDF files into EDGAR, found in the EDGAR Filer’s Manual, available at
http://www.sec.gov/info/edgar.shtml.
b) If any other documents are required, as specified in Section C of the form, include these documents in the same PDF file or create a separate one(s).
c) Attach the PDF file(s) to the Form MA or Form MA-I, as appropriate, where prompted in the
form.

SEC 2900 (4/14)

Power of Attorney, Consent, Stipulation, and Agreement
A. Designation and Appointment of Agent for Service of Process
Identify the agent for service of process for the non-resident municipal advisor, for the non-resident
general partner or managing agent of a municipal advisor, or for the non-resident natural person
associated with the municipal advisor and engaged in municipal advisory activities on its behalf. Fill in
all lines.
1. Name of United States person designated and appointed as agent for service of process.
Enter all the letters of each name and not initials or other abbreviations.
(If no middle name, enter NMN on that line.)

_________________________________________________________
(name)
2. Mailing Address of United States person designated and appointed as agent for service of process.
Do not use a P.O. Box. Do not use a foreign address.
______________________________________________________________________
(number and street; office suite or room number)
__________________ _______
(city)
(state)

_____________________
(U.S. postal code: zip+4)

______________________________________
(area code) (telephone number)
By signing this Form MA-NR or authorizing the signatory below to sign on your behalf, you – the nonresident municipal advisor, non-resident general partner or non-resident managing agent of a municipal
advisor, or non-resident natural person who is a person associated with the municipal advisor and
engaged in municipal advisory activities on its behalf (hereinafter, “the Designator”) – irrevocably
designate and appoint the above United States person as your Agent for Service of Process, and agree
that such person may be served on your behalf, of any process, pleadings, subpoenas, or other papers,
and you further agree that such service may be made by registered or certified mail, in:
(a) any investigation or administrative proceeding conducted by the Commission (i) that relates to
you or (as applicable) to the municipal advisor of which you are a general partner or managing
agent, or with which you are associated and on whose behalf you are engaged in municipal
advisory activities or (ii) with respect to which you may have information; and
(b) any civil suit or action brought against you or (as applicable) the municipal advisor of which you
are a general partner or managing agent, or with which you are associated and on whose behalf
you are engaged in municipal advisory activities or to which you, or (as applicable) the
municipal advisor of which you are a general partner or managing agent, or with which you are
associated and on whose behalf you are engaged in municipal advisory activities has been joined
as defendant or respondent, in any appropriate court in any place subject to the jurisdiction of
any state, or of the United States or of any of its territories or possessions or of the District of
Columbia, where the investigation, proceeding, or cause of action arises out of or relates to or
concerns municipal advisory activities of the municipal advisor.

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The Designator stipulates and agrees that: any such civil suit or action or administrative proceeding may
be commenced by the service of process upon, and that service of an administrative subpoena shall be
effected by service upon, the above-named Agent for Service of Process; and that service as aforesaid
shall be taken and held in all courts and administrative tribunals to be valid and binding as if personal
service thereof had been made. Such person cannot be a Commission member, official, or employee.

Appointment and Consent: Effect on Partnerships. If you are organized as a partnership, this
irrevocable power of attorney and consent to service of process will continue in effect if any partner
withdraws from or is admitted to the partnership, provided that the admission or withdrawal does not
create a new partnership. If the partnership dissolves, this irrevocable power of attorney and consent
shall be in effect for any action brought against you or any of your former partners.

Certification:
The undersigned certifies under penalty of perjury under the laws of the United States of America, that
the information contained in this Form MA-NR is true and correct and that this Form MA-NR is signed
as a free and voluntary act.
Unless the Designator is a natural person signing on his or her own behalf, the undersigned further
certifies that the Designator has duly caused this power of attorney, consent, stipulation, and agreement
to be signed on the Designator’s behalf by the undersigned, thereunto duly authorized:

Signature of Designator or Person Signing on Behalf of Designator:
_____________________________________ Date: ____________________
Printed Name: ____________________________ Title: _________________
In the City of: __________________________ In the Country of: _______________________
The Designator is executing this Form MA-NR as a:
(Check all that apply.)
___ Non-resident municipal advisory firm, other than a sole proprietor
___ Non-resident natural person who is a person associated with the municipal advisor and engaged in
municipal advisory activities on its behalf
___ Non-resident municipal advisor sole proprietor
___ Non-resident general partner of a municipal advisor
Name of municipal advisor ______________________________________
___ Non-resident managing agent of a municipal advisor
Name of municipal advisor ______________________________________
The Designator is executing this Form MA-NR in connection with a(n):
(Check all that apply.)
___Initial application on Form MA of the Designator for registration as a municipal advisor
___Initial application on Form MA of the municipal advisor of which the Designator is a general partner
or managing agent
___Initial submission on Form MA-I filed regarding a natural person who is a person associated with the
municipal advisor and engaged in municipal advisory activities on its behalf

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___Change of status of Designator from a resident to a non-resident
___Amendment to information supplied on a previous Form MA-NR
Mailing Address of the Designator
Do not use a P.O. Box.

______________________________________________________________________
(number and street)
__________ ___________
(city)
(state/region)

_________
(country)

_____________________________
(postal code)

________________________________________
(country code) (area code) (telephone number)
For a telephone number outside of the U.S., provide the country code with the area code and number.
EDGAR CIK No. (if any)___________ SEC File No. (if any): ______________

Notary Public Signature and Information:
Signature: _________________________________

[PLACE SEAL HERE]

Subscribed and sworn to me this ____ day of __________, ______
My commission expires on _______________
State/Region of ________________________

County of ______________________
Country of _____________________

B. Acceptance of the Above Designation and Appointment as Agent for Service of Process.
The United States person identified in Section A above as the agent for service of process hereby accepts
this designation and appointment as agent for service of process, under the terms set forth in this Form
MA-NR. By signing below, the signatory certifies that the person identified in Section A above as the
agency for service of process has duly caused this power of attorney, consent, stipulation, and agreement
to be signed on its behalf by the undersigned, thereunto duly authorized:
Signature of U.S. Agent for Service of Process:
_____________________________________ Date: _________________________
Printed Name: _________________________ Title: _________________________

C. Attached Documents
1. Is any name signed above pursuant to a written authorization, such as a board resolution or power of
attorney?
Yes
No
2. Is there a written contractual agreement or other written document evidencing the designation and
appointment of the above named U.S. agent for service of process and/or the agent’s acceptance?
Yes
No

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If “Yes” to Section C-1 and/or Section C-2., identify each such document on a separate line below, and
include an accurate and complete copy of each such document as part of the PDF file in which the Form
MA-NR is attached to the Form MA or Form MA-I, or attach each such document as a separate PDF to
the relevant Form MA or Form MA-I.

________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________

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