arbitration claim filing guide - finra.org table of contents introduction to dispute resolution 2...
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Dispute Resolution January 2017 Edition
Arbitration Claim Filing Guide
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TABLE OF CONTENTS
Introduction to Dispute Resolution 2
PART ONE: Filing the Initial Statement of Claim 4
PART TWO: Filing Statements of Answer 9
PART THREE:Filing Other Claim(s) 10
PART FOUR: General Information 11
Claim Information Sheet 14
FINRA Arbitration Submission Agreement 23
ARBITRATION CLAIM FILING GUIDE
FINRADisputeResolutionOneLibertyPlaza27thFloor165BroadwayNewYork,NewYork10006
www.finra.org/arbitration_mediation
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1 FINRAalsoprovidesdisputeresolutionservicesforseveralnon-FINRAexchangesthroughcontractedagreements.Byagreementwiththeseotherexchanges,theexchangesadoptFINRA’srulesandsubjectthefirmsregisteredwiththeexchangestoFINRADisputeResolution’srulesandprocedures.ThefollowingexchangeshaveagreementswithFINRAfordisputeresolutionservices:BATSExchange,BOXOptionsExchange,LLC(BOX),ChicagoBoardOptionExchange(CBOE),DirectEdge,InternationalSecuritiesExchange(ISE),MIAXOptionsExchange(MIAX),MunicipalSecuritiesRulemakingBoard(MSRB),NASDAQ,NASDAQOMX(includestheformerBostonStockExchangeandPhiladelphiaStockExchange),NewYorkStockExchange,NYSEAmexandNYSEArca.Theagreementswiththeseexchangesofferfirmsandinvestorsconsistencyofproceduresandtheuniformityofasingleforumfortheresolutionofsecuritiesindustryrelateddisputes.ContactFINRADisputeResolutionstafftodeterminewhetherapotentialpartymaybesubjecttomandatoryarbitrationinFINRA’sforumunderoneoftheagreements.
2 TheCode of Arbitration Procedureisseparatedintothreeparts: theCustomer Code, the Industry CodeandtheMediation Code.
Introduction to Dispute Resolution
FINRAsponsorsaforumforsecuritiesdisputeresolution.Ourarbitrationprogramadministersclaimsinvolvingcustomersofbrokeragefirmsanddisputesbetweenbrokeragefirmsandtheiremployees.Wealsoofferafull-scopemediationprogram.
Mediationandarbitrationarenon-judicialmethodsofresolvingdisputesbetweentwoormoreparties.Anytypeofdispute,claimorcontroversyarisingoutofbusinessdealingswithanyFINRAbrokeragefirm1canberesolvedinmediationorarbitration.
Consider Mediation First
Beforeyou,apotentialclaimant,initiatearbitrationorcourtlitigation,considermediatingyourclaimsincethisisanaturalfirststepinthedisputeresolutionprocess.
Mediationisaninformalprocessinwhichamediatorfacilitatesnegotiationsbetweendisputingparties.Themediator’sroleistohelpthepartiesfindamutuallyacceptablesolutiontothedispute.
Inmediation,youandtheotherpartiescontrol:
00 whothemediatorwillbe;
00 whenthemediationwilloccur;and
00 howthedisputewillberesolved.
Partieswhomediateatthisforumresolvefouroutofeveryfivecases.Inaddition,resolutioncanbefasterandlessexpensivethaninarbitrationorlitigation.Ifyouandtheotherpartiesagreetomediate,youwillnotgiveupanyrighttoarbitrateorlitigateifafullsettlementisnotreached.
Formoreinformationonourmediationprogram,pleaseseethepublicationFINRAMediation—AnAlternatePathtoResolvingSecuritiesDisputes,availableonourWebsiteatwww.finra.org/arbitration_mediation.
FINRA Arbitration
Ifallpartiesdonotfullysettletheirclaimsoryoudecidetoarbitrateyourclaimwithoutmediation,youmaysubmityourclaimtoFINRA.Inarbitration,animpartialpersonorpanelhearsthepresentationsoftheparties,evaluatestheevidenceanddecideshowthematterwillberesolved.Whenyouchoosearbitrationtoresolveyourdispute,youforegotheopportunitytohavethesamematterdecidedbyacourtoflawbecauseanarbitrationawardatthisforumisfinalandbinding.
ThisArbitration Claim Filing Guideprovidesinformationforyouandallpartiesinvolvedinarbitrationproceed-ings.TheguideexplainshowtofileaninitialStatementofClaimandotherpleadings.Italsooutlinesthewaypleadingsshouldbeservedupontheotherparties,andprovidesinformationandguidanceonotheraspectsofthearbitrationprocess.
PartiestoFINRAarbitrationsormediationsareboundbyFINRA’srules.TheCode of Arbitration Procedure2containstheformalrulesthatgovernarbitrationsandmediationsadministeredbyFINRA.TheCodeisavailableonourWebsiteatwww.finra.org/arbitration_mediation.TakethetimetoreadandunderstandtheCode.Inaddition,pleasereviewourWebsiteasitcontainsadditionalimportantinformationaboutFINRA’scaseadministrationprocessesandprocedures.
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Ifyouhaveanyquestions,calltheappropriateFINRADisputeResolutionoffice,MondaythroughFriday,between9a.m.and5p.m.
FINRA is not authorized to give you legal advice or to comment on the merits of your case. If you feel that you need legal advice, consult a lawyer.
FINRA DISPUTE RESOLUTION OFFICES
Northeast Region
FINRADisputeResolutionOneLibertyPlaza,27thFloor165BroadwayNewYork,NY10006(212)858-4200Fax:(301)[email protected]
Western Region
FINRADisputeResolution300S.GrandAvenue,Suite1700LosAngeles,CA90071(213)613-2680Fax:(301)[email protected]
Southeast Region
FINRADisputeResolutionBocaCenterTower15200TownCenterCircle,Suite200BocaRaton,FL33486(561)416-0277Fax:(301)[email protected]
Midwest Region
FINRADisputeResolution55WestMonroeStreet,Suite2600Chicago,IL60603-1002(312)899-4440Fax:(312)[email protected]
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PART ONE: Filing the Initial Statement of Claim
3 Seeremarksatfootnote1.
1. Statement of Claim
YoubeginthearbitrationprocessbyfilingaStatementofClaim,whichisawrittennarrativethatsetsforththefactsofthedispute.WhiletheStatementofClaimdoesnothavetobeinaspecialform,itshouldsetforththedetailsofthedispute,includingallrelevantdatesandnames,inaclear,conciseandchronologicalfashion,andshouldconcludebyindicatingwhatrelief(e.g.,theamountofmoneydamages,specificperformance,interest,etc.)isrequested.
IfyourStatementofClaimreferstodocuments,copiesofthedocumentsshouldbeattachedasexhibits.ExhibitsmustbeclearlyidentifiedandacompletesetshouldbeattachedtoeachcopyoftheStatementofClaim.NumbereachpageofyourStatementofClaimtoindicatethepagenumberandthetotalamountofpages.Forexample,ifyourStatementofClaimcontainsfourpages,numberthepagesasfollows:“Page1of4,”“Page2of4,”“Page3of4”and“Page4of4.”
Exceptforarbitrationawards,whicharepubliclyavailable,thedocumentsandinformationinFINRADisputeResolutioncasefilesareconfidential.FINRADisputeResolutionlimitsaccesstopersonalconfidentialinformationtoFINRAstaffmemberswhoneedittoperformtheirjobfunctions,andtoarbitrators,mediatorsorotherindividualsinvolveddirectlyinthearbitrationormediationprocess.Examplesofpersonalconfidentialinformationinclude:
00 SocialSecuritynumbers;
00 Brokerage,bankorotherfinancialaccountnumbers;
00 Taxpayeridentificationnumbers;and
00 Medicalrecords.
Partiesandtheircounselalsoshouldtakestepstoprotecttheirconfidentialinformation.Partiescansafeguardpersonalconfidentialinformationbyredactingsuchinformationfrompleadings,exhibitsandotherdocumentsuponagreementoftheparties.Forexample,thepartiesmayagree:
00 NottouseortoredactSocialSecurity,accountordriverlicensenumbers;and
00 Wheresuchdatamustbereferenced,touseonlythelastfewdigitsofsocialsecurity,bankoraccountnumbers,orsimilarinformation.
Ifyouincludeanemployeeofabroker-dealerasarespondent,theemployee’snameandcurrentbusinessaddressshouldbeprovidedontheenclosedClaimInformationSheet.Ifyoudonotknowtheemployee’scurrentbusinessaddress,FINRAwillattempttoobtainit.Iftherespondentemployeeisnotcurrentlyworkingasabroker,youshouldprovidetheemployee’scurrentresidentialaddressontheenclosedClaimInformationSheet,ifknown.IfFINRAcannotlocateanemployeerespondent,youwillberequiredtoprovideavalidaddressfortherespondent.
Ifyouareaclaimantfirm3andtherespondentisapubliccustomer,youmustinclude,withyourStatementofClaim,acopyofthepredisputeagreementsignedbythecustomertoarbitratethisdisputewithyouatthisforum.Ifyoudonotfileacopyofthecustomerpredisputearbitrationagreement,youwilldelaytheprocessingofyourclaim.
ThetextofyourStatementofClaimshouldcontainanexplanationofhowandwhyeachoftherespondentsisliable.
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QUESTION: Can I file my arbitration claim online?
AnypartymaysubmitanarbitrationclaimthroughtheFINRAOfficeofDisputeResolution’sDRPortal.Onlinefilingisaconvenientwaytofileanarbitrationclaim.FINRAwillmakecopiesofyourdocumentstoserveontherespondentsandforthearbitrators.Claimsaredeemedfiledwhentheclaimantsubmitstheclaimelectronicallythroughtheportal.Filingonlineallowsyouto:
00 completeanonlineClaimInformationForm;
00 submitaStatementofClaim,signedSubmissionAgreementandothersupportingdocumentationelectronically(nohardcopysubmissionsrequired);
00 paythefilingfeesonline;
00 generateaprintablereceiptwithtrackingnumber;and
00 savemultiplepartiallycompletedclaimsandreturntothemlater.
TheDRPortalalsoallowspartiesto:
00 viewcasedocuments;
00 submitdocumentstoFINRAandsenddocumentstootherportalcaseparticipants;
00 schedulehearingdates;
00 viewdetailsofupcominghearings;and
00 rankandstrikearbitratorsduringlistselection.
PartiescanaccesstheDRPortalat:https://drportal.finra.org
TheDRPortalUserGuideandFAQcanbefoundat:http://www.finra.org/arbitration-and-mediation/dispute-resolution-portal-user-guides.
EffectiveJuly20,2015,webeganinvitingallpartiesinallnewcasestousetheportalonavoluntarybasis.Wewillinviteclaimantstousetheportalimmediatelyuponreceiptoftheclaimattheregionalofficeandwillinviterespondentstousetheportalimmediatelyuponreceivinganoticeofappearance,requestforextension,orstatementofanswerfromrespondents’counsel.
QUESTION: What is the dollar amount of your claim?
Ifyourclaimis$50,000 or less,itwillbeclassifiedasa“simplifiedarbitration.”Theprocedureforprocessingasimplifiedarbitrationisasfollows:
00 Onearbitratordecidesasimplifiedarbitration.
00 Thecasewillbedecidedexclusivelyonthefileddocuments(withoutahearing)unlessthecustomerinacustomercaseortheclaimantinanindustrycaserequestsoragreestoahearing.
Ifthetotalamountincontroversyis more than $50,000 and up to $100,000,exclusiveofinterestandexpenses,onearbitratorwillbeselectedtodecidethecaseunlessbothpartiesagreeinwritingtoapanelofthreearbitrators.
Ifthetotalamountincontroversyismore than $100,000 or an unspecified or non-monetaryamount,apanelofthreearbitratorswillbeselectedtodecidethecase.
2. Arbitration List Selection
QUESTION: Can parties in an investor case have a panel of all public arbitrators decide the case?
FINRAwillappointasinglepublicarbitratorincustomercasesdecidedbyonearbitrator.
Incustomercasesdecidedbythreearbitrators,FINRARule12403allowsanypartytoselectanallpublicpanelofarbitrators.EffectiveforallarbitratorlistsFINRAsendstopartiesonorafterJanuary3,2017,FINRAwillsendthepartiesthreelists–onewith10chair-qualifiedpublicarbitrators,onewith15publicarbitrators,andonewith10non-publicarbitrators.Eachseparatelyrepresentedpartymaystrikeuptofourofthe10arbitratorsonthechair-qualifiedpubliclistforanyreasonbycrossingthroughthenamesofthearbitrators(atleastsixnamesmustremainonthechair-qualifiedpubliclist).Eachseparatelyrepresentedpartymaystrikeuptosixofthe15arbitratorsonthepubliclistforanyreasonbycrossingthroughthenamesofthearbitrators(atleastninenamesmustremainonthepubliclist).Bystrikingallofthearbitratorsonthenon-publiclist,anypartycanensurethatthepanelwillhavethreepublicarbitrators.FINRAwillnotappointanon-publicarbitratortothepanelwhohasnotbeenselectedbytheparties.
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4 Seeremarksatfootnote1.
QUESTION: As a party in an intra-industry case, which arbitrators will decide my case?
Partiesinintra-industrycasesshouldrefertotheCode of Arbitration Procedure for Industry Disputesforinformationonarbitratorlistselection.
3. Submission Agreement
AnoriginalSubmissionAgreementalsomustaccompanyyourStatementofClaim(seep.23).TheSubmissionAgreementisadocumentthatsignifiesthatyouelecttosubmitaclaimtoFINRAandtoabidebytheselectedarbitrator(s)’decisionontheinitialclaimandonanyotherrelatedclaimthatotherpartiesserveandfile.Therefore,partiesshouldnotalterthelanguageoftheSubmissionAgreement.
OnceyousignandfileaSubmissionAgreementwithFINRA,theproceduresandtimingsetoutintheCodes becomeoperativeandbinding.ASubmissionAgreementforclaimantsisincludedinthisguide.Youmaycopytheformasneeded.
Thearbitrationprocesswillbeginonlywhenallclaimantsortheirproperlyauthorizedrepresentativessign,dateandfiletheSubmissionAgreements.
BysigningtheSubmissionAgreement,youarestatingthatyouareoneofthefollowing:(1)theclaimant;or(2)apersonwithlegalauthoritytobindtheclaimant;or(3)apersonwithfirsthandknowledgeofthefactsandactualorimpliedauthoritytoactonbehalfoftheclaimant;or(4)anattorneywhohasactualorimpliedwrittenorverbalpowerofattorneyfromtheclaimanttosignontheclaimant’sbehalf,andthus,bindtheclaimanttothetermsoftheSubmissionAgreement,asiftheclaimantpersonallysignedtheform.
Youmustcompletethe“Claimant”and“Respondent”portionsonthefrontofaSubmissionAgreement.Intheblankspacesprovidedfortheclaimants’names,youshouldwriteortypethenameofeachclaimantfilingtheStatementofClaim.Publiccustomerclaimantsshouldlistthemselvesthesamewaytheaccountwaslistedwiththebroker-dealer.Forexample,
(1) ifyouraccountwasajointaccountlistedas“TomSmithandMarySmith,JTWROS,”itshouldbewrittenortypedinthismannerundertheclaimantheading.
(2) ifyouhadtwoaccounts,apersonalandanIRA,theyshouldbewrittenortypedas“JohnSmithandJohnSmith,IRA.”
00 ClaimantsmustcompletetherespondentportionoftheSubmissionAgreement.Intheblankspacesprovidedfortherespondents’names,youshouldwriteortypethenameofeachrespondentyoubelieveisliable.
00 Therespondent(s)listedontheSubmissionAgreementmustbeidenticalwiththoseappearinginyourStatementofClaim.Iftheyarenotidentical,youwilldelaytheprocessingofyourclaim.
00 Donotlist“JohnDoe”respondentsintherespondentportionoftheSubmissionAgreement.FINRADisputeResolutionwillnotserveunidentifiedrespondents.Ifyoulist“JohnDoe”respondents,youwilldelaytheprocessingofyourclaim.PleasereviewtheAmendmentstoPleadingssectiononpage10.
4. Respondents – Active Firms
Inacustomercase,therespondentshouldbeeitherafirmand/orsomeoneassociatedwithafirm.4TodeterminewhethertherespondentsyouarenamingareFINRAfirmsorassociatedpersons,youmayconsulttheFINRA’sBrokerCheckprogramontheWebatwww.finra.org/BrokerCheck,orcalltheBrokerCheckHotlineat(800)289-9999MondaythroughFridayfrom8a.m.to8p.m.EasternTime.
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5. Respondents – Terminated Firms
UnderRule12202ofthe Customer Code,aFINRAfirmwhosemembershipisterminated,suspended,canceledorrevoked,orthathasbeenexpelledfromFINRAorarelatedexchange,orthatisotherwisedefunctisprohibitedfromenforcingpredisputearbitrationagreementswithitscustomerstoarbitrateatFINRAunlessthecustomersagreeinwritingtodosoaftertheclaimhasarisen.Ifthecustomerchoosesnottoproceedwiththeclaiminthisforum,andhasnotagreedtoarbitratetheclaiminanotherforum,heorshemaybeabletobringthisclaimincourt.
FINRAwillassumethatthecustomerwantstoproceedwiththeclaiminthisforum,baseduponthesignedSubmissionAgreement.However,FINRAwillnotifythecustomerifthefirm’smembershipstatusisinactiveandofitsintenttoservetheclaim,unlesstheclaimantsubmitswrittennoticewithin30calendardaysthatheorshedoesnotwanttoarbitratetheclaiminthisforum.
Theaboveruledoesnotaffectcustomerclaimsinvolvingafirmthathasbeenacquiredbyanotherfirmthatassumesitsliabilities.Also,itdoesnotaffectclaimsinvolvinganassociatedpersonwhoseregistrationhasbeenbarred,terminated,revokedorsuspended.
Ifthecustomerdecidestoproceedwiththeclaiminthisforum,heorsheshouldbeawarethatarbitrationawardsagainstafirmwhosemembershipstatusisterminated,suspended,canceled,revoked,expelledorotherwisedefunct,haveamuchhigherincidenceofnon-paymentthanthoseagainstactivefirms.TheclaimantshouldalsobeawarethatFINRAhasonlylimiteddisciplinaryauthorityoverinactivefirmsthatfailtosatisfyarbitrationawards.
Tosavetime,beforefilinganarbitrationclaimyou:
00 MayreviewtheFINRAPublicDisclosureProgramtodeterminethefirm’sFINRAmembershipstatus.(CustomersmayaccessFINRA’sBrokerCheckprogramontheWebatwww.finra.org/BrokerCheck,orcalltheBrokerCheckHotlineat(800)289-9999MondaythroughFridayfrom8a.m.to8p.m.EasternTime.)Customersmayalsoreviewthefirm’smembershipstatusattheappropriateexchange.
00 Shoulddeterminewhetheryouwishtoproceedinarbitrationagainstaformerfirmorgotocourt.
Ifyoudeterminethatyouwishtoproceedinarbitration,adviseFINRA,inwriting,thatyouwanttoproceedagainstthefirmwhosemembershipstatuswasterminated,suspended,canceled,revoked,expelledorotherwisedefunct.Failuretoprovidethiswrittenstatementwithyourclaimwilldelaytheprocessingofyourarbitrationcase.
6. Fees
YoumustpayafilingfeeatthetimeyoufileyourStatementofClaim.Theamountofthisfeeisbasedonthetotalamountofyourclaimincludinganypunitiveandtrebledamagesbutexcludinginterestandexpenses.Onecheckforthefilingfeemustbemadepayableto“FINRADisputeResolution.”UsePartsIIIandIVoftheClaimInformationSheettodeterminethecorrectfee.
FINRAwillprocessyourclaimonlyifthecorrectfilingfeeissubmitted.However,youcanobtainatemporarywaiverofthefilingfeeifyoucandemonstrateafinancialhardship.
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QUESTION: How does FINRA credit a filing fee paid by one claimant, by claimants’ representative or by a non-party, in cases with multiple claimants?
00 Ifaclaimincludesmultipleclaimants,theclaimantscollectivelyoweasinglefilingfee.FINRAwillacceptacheckfromanyoftheclaimants,fromthepartyrepresentativeorfromanon-partyonbehalfoftheclaimants.
00 Ifoneclaimantpaysthefilingfee,FINRAwillcreditthepayingclaimanttheamountofthecheck.
00 Ifclaimants’representative,oranon-party,paysthefilingfeeonbehalfoftheclaimants,FINRAwillcredittheamountofthechecktothefirstnamedclaimantintheStatementofClaim.
00 Theseproceduresalsoapplytocounterclaims,crossclaimsandthirdpartyclaimsfiledonbehalfofmultiplerespondents.
QUESTION: How does FINRA use the filing fee paid by one claimant or by claimants’ representative, in cases with multiple claimants?
00 Attheconclusionofthecase,FINRAwillusethefilingfeechecktopayfeesowedbyanyclaimant.
00 FINRAwillevenlydistributethefundstopayeachclaimant’sfees.Ifanyfundsremainforanyoftheclaimants,FINRAwillusethosefundstopaythebalanceoffeesowedbyanyotherclaimants.
00 Theseproceduresalsoapplytocounterclaims,crossclaimsandthird-partyclaimsfiledonbehalfofmultiplerespondents.
QUESTION: How do I request a waiver of the filing fee?
00 Makeawrittenrequestforthewaiverstatingthereason(s)thatwouldmakepaymentofthefilingfeeafinancialhardship.
00 Includewiththewrittenrequestforwaiverthefollowinginsupportoftherequest:acopyofyourmostrecentlyfiledtaxreturn;twoofyourmostrecentpaystubs;anddocumentationofgarnishmentorlien,orotherdocumentsthatevidencehardship.
00 Ifyouareunabletoprovidethisdocumentationinsupportoffinancialhardship,submitanaffidavitattestingtoyourfinancialhardship.
00 Thestaffpersonassignedtoyourcasewillinformyouinwritingofthedecisiontograntordenyyourrequestforawaiveroffees.Intheeventyourrequestisgranted,rememberthewaiveristemporaryinnature.Theselectedarbitrator(s)willmakeafinaldecisionontheassessmentofthesefeesafterconsideringanumberoffactors,includingthedocumentationyousuppliedinsupportofthewaiverrequest.
00 Beawarethatforumfeesaccrueforeachprehearingconferenceandforeachhearingsessionconducted.Ahearingsessionisanymeetingwiththearbitrator(s)thatlastsfourhoursorless.
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PART TWO: Filing Statements of Answer
7. Claim Information Sheet
TheClaimInformationSheet(InformationSheet)(seep.14)isasynopsisoftheinformationcontainedinyourStatementofClaim.FINRArequeststhatyouvoluntarilycompleteandfilewiththeNewYorkDisputeResolutionOfficeallpartsoftheInformationSheetinthispacketbecauseitwillhelptheassignedstafftoquicklyaccessthefactsofyourcase.The Information Sheet is not a substitute for a Statement of Claim.
QUESTION: How do you file your Statement of Claim?
FileyourStatementofClaimwithFINRA’sNewYorkOffice(theaddressisonthecoverofthisguide).Assembleyourdocumentsinthefollowingorder:
1. Checkormoneyorder(DONOTSENDCASH)
2. SubmissionAgreement(s)(withadditionalcopies)
3. ClaimInformationSheet
4. StatementofClaimandExhibits
Uponreceiptofyourfiling,yourcasewillbeassignedtotheappropriateregionalofficeandyouwillbeprovidedwithacasenumber.
FINRAwillnotifyyouofthestaffpersonassignedtoyourcaseduringthisstageoftheprocess.Youmaydirectanyquestionstothatstaffperson.Alwaysreferenceyourcasenumberwhenyouwriteorcallaboutyourcasetoenablethatstaffmembertoassistyouquickly.
QUESTION: Who will serve the Statement of Claim?
FINRAwillserveyourStatementofClaimoneachoftherespondentsthatyoulistandagainstwhomyouassertaclaim.FINRAalsowillnotifytherespondentsandyouoftheanticipatedinitialhearinglocationofthecase.
AftertheinitialStatementofClaimisserved,FINRAisnotobligatedtoserveanypleadings,motionsorcorrespondenceonanyparty.YouandtheotherpartiesmustserveandfiletheseotherdocumentsasdescribedinPartsTwo,ThreeandFourofthisguide.
Ifyouarearespondent,theentityorpersonrespondingtoaclaim,theCodesallowyou45calendardaystoserveandfileanswerstoclaims.
Youranswermustspecifyalldefensesavailabletoeachclaim.
QUESTION: How do you serve and file a Statement of Answer?
Incontrasttotheinitialclaim,whenyouansweraclaimyoumustserveeverypartywithcopiesofyourexecutedSubmissionAgreementandanswer.Partiesincludeallrespondentsandclaimants.
Atthesametime,youmustfileanoriginalexecutedSubmissionAgreementandanswerwiththeFINRADisputeResolutionofficedesignatedintheserviceofclaimletter.
Youshouldestablishproofofservice.Proofofserviceisasignedstatementindicatingthedate,timeandmannerofservice.
QUESTION: Can you obtain an extension of time to serve and file your answer?
Withclaimants’writtenconsent,youmayobtainextensionsoftimetoanswer.
FINRAstaffwillnotgrantyouanextensionoftimetoanswer,exceptuponashowingofgoodcause.
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Withyouranswer,youalsomayserveandfileclaims.Thetypesofclaimsincludethefollowing:
1. counterclaimsthatareassertedagainstclaimants;
2. cross-claims thatareassertedagainstalreadynamedco-respondents;and
3. third-party claimsthatareassertedagainstapartynotnamedinanypreviouspleading.
Ifyouassertcounterclaims,cross-claimsorthird-partyclaims,thefilingfeewillbedeterminedbythehighestclaimamount,excludinginterestandexpenses.Todeterminethecorrectfee,seePartsIIIandIVoftheClaimInformationSheet.Acheckforthefeemustbemadepayableto“FINRADisputeResolution.”
QUESTION: How do you serve and file counterclaims and cross-claims?
Youmustserveeverypartyyoulistandagainstwhomyouassertaclaimwithacopyofyouranswercontainingacounterclaimorcross-claim,andyoushouldestablishproofofservice.
Youalsomustsendonecopyoftheanswercontainingyourclaim(s)andtheexecutedSubmissionAgreementtoallotherpartiesfortheirinformationandreview.
Atthesametime,youmustalsosendacopyoftheanswercontainingyourclaim(s)andtheexecutedSubmissionAgreementtotheregionalofficeadministeringyourclaim.
PART THREE: Filing Other Claim(s)
QUESTION: How do you serve and file third-party claims?
Youmustserveeverynewpartyyoulistandagainstwhomyouassertaclaimwithacopyofyouranswercontainingthird-partyclaim(s),andyoushouldestablishproofofservice.
Youalsomustservethenewrespondentwith:
00 theStatementofClaimandallotherpleadings;and
00 acopyofthisguide.
Youmustsendonecopyoftheanswercontainingyourthird-partyclaim(s)andtheexecutedSubmissionAgreementtoallotherparties.
Atthesametime,youmustalsosendacopyoftheanswercontainingyourclaim(s)andtheexecutedSubmissionAgreementtotheregionalofficeadministeringyourclaim.
1. Amendments to Pleadings
YoumustservedirectlyonallpartiesamendmentstoStatementsofClaimandStatementsofAnswer.IfyoureceiveanamendmentyoumustreviewRule12310oftheCustomer CodeorRule13310oftheIndustry Codetodetermineyourtimetofilearesponsetotheamendment.Ifyouamendyouranswertoincludeacounterclaim,cross-claimorthird-partyclaim,youmustserveitinaccordancewiththeinstructionscontainedinPartsTwoandThreeofthisguide.
Atthesametime,youmustfileacopyofthe
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amendmentwiththedesignatedFINRADisputeResolutionoffice.
IfyouamendaninitialStatementofClaimorifyouamendaStatementofAnswertoaddanewrespondent,youmustservethenewrespondentwith:
00 theamendment;
00 theStatementofClaimandallotherpleadings;and
00 acopyofthisguide.
Ifyouareanewrespondent,youhave45calendardaystoserveandfileananswerandanyrelatedclaiminaccordancewiththeinstructionscontainedinPartsTwoandThreeofthisguide.
Ifyoureceiveanamendedanswercontainingacross-claim,youhave20calendardaysfromthedateyouranswerisdue,orfromreceiptofthecross-claim(whicheverislater)toserveandfileananswerandanyrelatedclaiminaccordancewiththeinstructionscontainedinPartsTwoandThreeofthisguide.
Onceapanelhasbeenappointed,apartymayonlyamendapleadingifthepanelgrantsamotiontoamend.OncetherankedarbitratorlistsareduetotheDirector,nopartymayamendapleadingtoaddanewpartyuntilapanelhasbeenappointedandthepanelgrantsamotiontoaddtheparty.
PART FOUR: General Information
2. Hearing Locations
Afterallpleadings(claims,answers,counterclaims,replies,cross-claimsandthird-partyclaims)areservedandfiled,FINRAwillnotifyyouandtheotherpartiesinwritingofitsfinaldecisionontheinitialhearinglocation.
FINRAconductshearingsinatleastonecityineverystate,aswellasinLondon,EnglandandSanJuan,PuertoRico.
National Hearing Locations
Alabama:Birmingham
Alaska: Anchorage
Arizona:Phoenix
Arkansas:Little Rock
California: Los Angeles, San Diego, San Francisco
Colorado: Denver
Connecticut: Hartford
Delaware: Wilmington
Florida:Boca Raton, Jacksonville, Miami, Orlando, Tampa
Georgia:Atlanta
Hawaii:Honolulu
Idaho:Boise
Illinois:Chicago
Indiana: Indianapolis
Iowa:Des Moines
Kansas: Wichita
Kentucky: Louisville
Louisiana: New Orleans
Maine: Augusta
Maryland: Baltimore
Massachusetts: Boston
Michigan: Detroit
Minnesota: Minneapolis
Mississippi: Jackson
Missouri: Kansas City, St. Louis
Montana: Helena
Nebraska: Omaha
Nevada: Las Vegas, Reno
NewHampshire: Manchester
NewJersey: Newark
NewMexico: Albuquerque
NewYork: Albany, Buffalo, New York, Syracuse
NorthCarolina: Charlotte, Raleigh
NorthDakota: Bismarck
Ohio: Cincinnati, Cleveland, Columbus
Oklahoma: Oklahoma City
Oregon: Portland
Pennsylvania: Philadelphia, Pittsburgh
RhodeIsland: Providence
SouthCarolina: Columbia
SouthDakota: Rapid City
Tennessee: Memphis, Nashville
Texas: Dallas, Houston
Utah: Salt Lake City
Vermont: Montpelier
Virginia: Norfolk, Richmond
Washington,DC
Washington: Seattle
WestVirginia: Charleston
Wisconsin: Milwaukee
Wyoming: Cheyenne
England:London PuertoRico: San Juan
International Hearing Locations
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5 “Withoutprejudice”meanswithoutinterferingwithanyexistingrightyoumayhavetorefilethisclaimatthisoranotherforum.
Hearing Location
InaccordancewithRule12213oftheCustomer Codeifanarbitrationdisputeinvolvesapublic customer,FINRAwillgenerallyselectthehearinglocationclosesttothecustomer’sresidenceatthetimethedisputearose,unlessthecustomerrequestsinhis/herinitialfilingahearinglocationinthecustomer’sstateofresidenceatthetimethedisputearose.
Forexample,ifaKansasresidentlivesonlyfivemilesfromKansasCity,Missouri(anddidsoatthetimethedisputearose),butspecifiesWichita,Kansasashisrequestedhearinglocation—alocationmorethanfivemilesfromhisresidence—FINRAwouldselectWichitaasthehearinglocation.
InaccordancewithRule13213oftheIndustry Code,ifanarbitrationinvolvesanemployment disputebetweenafirmandanassociatedperson,FINRAgenerallywillselectthehearinglocationthatisclosesttothelocationwheretheassociatedpersonwasemployedatthetimethedisputearose,unlesstheassociatedpersonrequestsinhis/herinitialfilingahearinglocationintheassociatedperson’sstateofemploymentatthetimethedisputearose.
PerRule13213,inindustrydisputesinvolvingFINRAfirmsonly,unlessthefirmsarelocatedinthesamecity,FINRAwillconsideranumberoffactorswhendecidingthehearinglocation.Theseincludethefollowing:
00 signedagreementstoarbitrate;
00 whoinitiatedthetransactionsorbusinessatissue;and
00 locationofessentialwitnessesanddocuments.
Ifallpartiesinanyarbitrationagreetoahearinglocation,FINRAordinarilywillselectthathearinglocation.
3. Correspondence with Parties and FINRA
YoumustserveallpartiesandfilewithFINRAanycorrespondencesenttoparties—inadditiontopleadingsandamendments.
4. Settlement of a Claim
Claimant(s)mustwritedirectlytotheassignedstaffifanyclaimsettles.FINRAwillnotclosethecasewithoutreceivingwrittennoticefromtheclaimant.FailuretoadviseFINRAtimelyofasettlementofaclaimmayaffectclaimant’sentitlementtoareturnoftherefundableportionofthefilingfee.
5. Withdrawal of a Claim
Rule12702oftheCustomer Code andRule13702oftheIndustry Code provideforwithdrawalofaclaim:
00 Ifyouwishtowithdrawyourclaimaftertheclaimhasbeenservedandfiled,butbeforetherespondenthasservedandfiledtheanswer,youmaywithdrawtheclaimwithoutprejudice5byinformingtherespondentinwritingandcopyingthedesignatedFINRADisputeResolutionofficeandallotherparties.
00 Ifyouwishtowithdrawyourclaimaftertheclaimhasbeenservedandfiled,andaftertheanswerhasbeenservedandfiled,bytherespondent,youmaynotwithdrawtheclaimwithoutprejudice,unlesstherespondentagreestoawithdrawalwithoutprejudiceorwiththearbitrator(s)’consent.
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6. Payment of Fees
Anytimeafeeisassessedtoyouduringthecase,youwillreceiveaninvoicethatreflectsthefeeassessed.Attheconclusionofthecase,youwillreceiveaStatementofAccountthatreflectsthefeesassessedandanyoutstandingbalanceorrefunddue.FeesaredueandpayabletoFINRADisputeResolutionuponreceiptofaninvoiceandshouldberemittedtotheaddressspecifiedontheinvoice.
Allquestionsregardingassessmentoffeesshouldbedirectedtotheregionalofficeadministeringyourcase.AllquestionsregardingpaymentoffeesandrefundsshouldbedirectedtoFINRAFinanceat(240)386-5910.
7. Representation of Parties
Rule12208oftheCustomer CodeandRule13208oftheIndustry Codepermitpartiestoanarbitrationormediationtorepresentthemselvesortoberepresentedbyanattorneyadmittedtopracticeandingoodstandinginanyjurisdiction,unlessstatelawprohibitssuchrepresentation.Inaddition,anon-attorneymayrepresentparties,unlessstatelawprohibitssuchrepresentation,thepersoniscurrentlysuspendedorbarredfromthesecuritiesindustryinanycapacity,orthepersoniscurrentlysuspendedfromthepracticeoflawordisbarred.
FINRAmaintainsalistoflawschoolsecuritiesarbitrationclinics,whichproviderepresentationtoinvestorsatreducedornocost.Forhelpfindinganattorneyoralawschoolsecuritiesarbitrationclinic,pleasevisitourwebsiteathttp://www.finra.org/arbitrationandmediation/finradisputeresolution/optionsforinvestors/findanattorney/.
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If needed, copy this page to list additional claimants.
CLAIM INFORMATION SHEET
I. PARTIES
CLAIMANT(S):(Providethisinformationevenifyouarerepresentedbycounsel.)
Name
Address
City State ZipCode
DaytimeTelephone Fax# EmailAddress
Residenceduringthetimeofthedispute(ifdifferentfromabove):
Name
Address
City State ZipCode
Claimantisa:Publiccustomer Broker-dealer Personassociatedwithabroker-dealer
Ifyouchecked“Broker-dealer”or“Personassociatedwithabroker-dealer,”itisimportantthatyouprovidethecorrectBD/CRDnumber.TodeterminewhetherapartyisaFINRAfirmorassociatedperson,youmayconsultFINRA’sBrokerCheckprogramontheWebatwww.finra.org/BrokerCheck.
BD# CRD#
Claimant’s Counsel/Representative (if applicable):(Note:FINRArequiresthatpersonsrepresentingFloridainvestorsinarbitrationproceedingsconductedinoroutsideoftheStateofFloridaaffirmeitherthattheyarelicensedtopracticelawandprovideabaridentificationnumber,orthattheyarenotreceivingcompensationinconnectionwithrepresentingthepartyinthearbitrationproceeding.)
Name BarID#(ifapplicable)
Address
City State ZipCode
BusinessTelephone Fax# EmailAddress
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CLAIM INFORMATION SHEET
RESPONDENT(S)
Respondent #1:
Name
Address(ifknown)
City State ZipCode
BusinessTelephone Fax EmailAddress
Respondent#1isa:Publiccustomer Broker-dealer Personassociatedwithabroker-dealer
Ifyouchecked“Broker-dealer”or“Personassociatedwithabroker-dealer,”itisimportantthatyouprovidethecorrectBD/CRDnumber.TodeterminewhetherapartyisaFINRAfirmorassociatedperson,youmayconsultFINRA’sBrokerCheckprogramontheWebatwww.finra.org/BrokerCheck.
BD# CRD#
Respondent #2:
Name
Address(ifknown)
City State ZipCode
BusinessTelephone Fax# EmailAddress
Respondent#2isa:Publiccustomer Broker-dealer Personassociatedwithabroker-dealer
Ifyouchecked“Broker-dealer”or“Personassociatedwithabroker-dealer,”itisimportantthatyouprovidethecorrectBD/CRDnumber.TodeterminewhetherapartyisaFINRAfirmorassociatedperson,youmayconsultFINRA’sBrokerCheckprogramontheWebatwww.finra.org/BrokerCheck.
BD# CRD#
If needed, copy this page to list additional respondents.
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CLAIM INFORMATION SHEET
II. CLAIMS
Accounts:Ifthedisputeorclaiminvolvesactivitywithrespecttoanaccountoraccounts,pleaselisteachaccountandindicatethetypeofaccountitis(e.g.,jointaccount,custodialaccount,etc.)
1.
Name(exactlyasitappearsontheaccount) TypeofAccount
NameofFirmandBranchOffice DateAccountOpened
NameofRegisteredRepresentative
2.
Name(exactlyasitappearsontheaccount) TypeofAccount
NameofFirmandBranchOffice DateAccountOpened
NameofRegisteredRepresentative
3.
Name(exactlyasitappearsontheaccount) TypeofAccount
NameofFirmandBranchOffice DateAccountOpened
NameofRegisteredRepresentative
If needed, copy this page to list additional accounts.
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CLAIM INFORMATION SHEET
Type of Dispute: (Check where applicable)
a. Account Related
BreachofContract Exchanges Transfer
Collection FailuretoSupervise Other
Dividends MarginCalls
Errors/Charges Negligence
b. Executions
ExecutionPrice IncorrectQuantity Other
FailuretoExecute LimitVersusMarketOrder
c. Account Activity
BreachofFiduciaryDuty Manipulations Suitability
Churning Misrepresentations UnauthorizedTrading
Fraud OmissionofFacts Other
d. Employment
BreachofContract DiscriminationNationalOrigin Partnerships
Commissions DiscriminationRace PromissoryNotes
Compensation DiscriminationReligion SexualHarassment
DiscriminationAge DiscriminationSexualPreference TrainingContracts
DiscriminationDisability LibelorSlander WrongfulTermination
DiscriminationGender LibelorSlanderonFormU-5 Other
e. Trading Dispute
Buy-In Markups Transfers
D.K.s SellOuts Other
Manipulation StockLoan
f. Other
ClearingDispute Indemnification Underwriting
Defamation RaidingDisputes
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Annuities
VariableAnnuities
Auction-RateSecurities
CertificatesofDeposit
CollateralizedDebtObligations(CDOs)
CollateralizedMortgageObligations(CMOs)
Commodities(OtherthanFutures)
CommonStock
CorporateBonds
Exchange-TradedFunds
“FannieMaes”
“FreddieMacs”
Futures
“GinnieMaes”
GovernmentSecurities
HedgeFunds
LimitedPartnerships
MunicipalBonds
MunicipalBondFunds
MutualFunds
Options
PreferredStock
PrivateEquities
RealEstateInvestmentTrust
RepurchaseAgreements
ReverseConvertibles
ReverseRepurchaseAgreements
StockIndexFutures
StructuredProducts
Warrants/Rights
g. Type of Security(ies), Financial Instrument(s), and/or Investment(s) involved in the Dispute:
Other:
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CLAIM INFORMATION SHEET
III. RELIEF REQUESTED
1. Damages
ActualDamages Requested $ 1.(monetarysumrequiredtocompensateapartyfor
hisorherlossexcludinginterestsandexpenses)
PunitiveDamages Requested 2.(monetaryamountintendedtopunishthewrongdoer)
* AMOUNTINDISPUTE: 3.
* UsethisamounttocalculatethecorrectfilingfeeandhearingsessiondepositinPartIV.Thisamountmustmatchtheamountstatedinyourclaim.
Interest(includecalculations,ifpossible)
2. Other Type of Relief RequestedSpecificPerformance(Specifythetypeofspecificperformancesought)(specificperformancerequirespartiestotakeanaction,suchasturningoverownershipofstocks)
InjunctiveRelief(Specifythetypeofinjunctivereliefsought)(injunctionsrequirepartiestorefrainfromcertainactions)
3. Costs
(Providespecificamounts,ifknown.Ifnotknown,pleasemarkan“X”toindicatethecostsyouarerequesting)
ForumFees WitnessandProductionFees
Attorney’sFees OtherCase-RelatedCosts
4. Claims Requesting Expungement
AsofJanuary1,2016,FINRAwillaskpartiesrequestingexpungementto:(1)ProvideFINRAwiththeCRDoccurrencenumber(s)whichisthesubjectoftheexpungementrequest;(2)Providethecasenameanddocketnumberthatgaverisetothedisclosure,ifapplicable;(3)StatewhethertheyhavepreviouslyrequestedexpungementofthesamedisclosureinCRD,andifso,explaintheoutcomeofthatrequest;and(4)StatewhethertheyarecurrentlyorpreviouslyregisteredinCRDandprovidetheirCRDnumber.
PartiesshouldincludeallsubjectCRDoccurrencenumbersonthefirstpageoftheirexpungementrequest.Providingthisinformationwillensuretheaccurateandtimelyprocessingofallexpungementrequests.
Failing to provide this information may unnecessarily delay the proceedings.
IndividualswithCRDnumberscaninstantaneouslyaccesstheirregistrationandlicensinginformationbyrequestinganIndividualSnapshotReportat:Individual Snapshot Report.
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CLAIM INFORMATION SHEET
Customer or Associated Person Claimant
IV. FEES
TO DETERMINE THE CORRECT FEE, USE THE “AMOUNT IN DISPUTE” FIGURE ON LINE 3, PAGE 19.
IfyouareaCUSTOMER OR ASSOCIATED PERSON CLAIMANTusethistable(Rule12900ofthe Customer CodeorRule13900oftheIndustry Code)todeterminethefilingfeethatMUSTaccompanyaStatementofClaimwhenitisfiledwithFINRA.IfyourclaimdoesNOTdiscloseorspecifyamonetaryclaim,thefilingfeeis$1,575.
Findtheamountofyourdisputeonthechart,thenfindtheapplicableclaimfilingfee.
Filing Fees for Claims Filed by Customers, Associated Persons and Other Non-Members
Amount of Claim (exclusiveofinterestandexpenses) Filing Fee
$.01to$1,000 $50
$1,000.01to$2,500 $75
$2,500.01to$5,000 $175
$5,000.01to$10,000 $325
$10,000.01to$25,000 $425
$25,000.01to$50,000 $600
$50,000.01to$100,000 $975
$100,000.01to$500,000 $1,425
$500,000.01to$1,000,000 $1,725
$1,000,000.01to$5,000,000 $2,000
Over$5,000,000 $2,250
Non-Monetary/NotSpecified $1,575
Onceyouhavedeterminedthecorrectfilingfee,submititwithyourStatementofClaim.Forexample,ifyouareacustomerorassociated personclaimantandtheamountofyourclaimis$40,000,theclaimfilingfeeis$600.MailthecheckwithyourStatementofClaim,ClaimInformationSheetandproperlyexecutedSubmissionAgreement.
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CLAIM INFORMATION SHEET
Firm Claimant
TO DETERMINE THE CORRECT FEE, USE THE “AMOUNT IN DISPUTE” FIGURE ON LINE 3, PAGE 19.
IfyouareaFIRM CLAIMANTusethistable(Rule12900ofthe Customer CodeorRule13900oftheIndustry Code)todeterminethefilingfeethatMUSTaccompanyaStatementofClaimwhenitisfiledwithFINRA.IfyourclaimdoesNOTdiscloseorspecifyamonetaryclaim,thefilingfeeis$1,700.
Findtheamountofyourdisputeonthechart,thenfindtheapplicableclaimfilingfee.
Member Claimant
Amount of Claim (exclusiveofinterestandexpenses) Filing Fee
$.01to$1,000 $225
$1,000.01to$2,500 $350
$2,500.01to$5,000 $525
$5,000.01to$10,000 $750
$10,000.01to$25,000 $1,050
$25,000.01to$50,000 $1,450
$50,000.01to$100,000 $1,750
$100,000.01to$500,000 $2,125
$500,000.01to$1,000,000 $2,550
$1,000,000.01to$5,000,000 $3,400
Over$5,000,000 $4,000
Non-Monetary/NotSpecified $1,700
Onceyouhavedeterminedthecorrectfilingfee,youshouldcalculatetheappropriatemembersurchargeoutlinedonpage22andsubmitthetotalwithyourStatementofClaim.Forexample,ifyouareafirmclaimantandtheamountofyourclaimis$40,000,theclaimfilingfeeis$1,450,andthemembersurchargeis$750.Therefore,youshouldsendonecheckpayable to FINRA Dispute Resolutionintheamountof$2,200.MailthecheckwithyourStatementofClaim,ClaimInformationSheetandproperlyexecutedSubmissionAgreement.
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CLAIM INFORMATION SHEET
Member Surcharge & Process Fees
Rules12901and12903oftheCustomer Code,andRules13901and13903oftheIndustry Coderequirefirmstopayanon-refundablesurchargeandnon-refundableprocessfeesifthefirmorpersonassociatedwiththefirmisaclaimantorrespondentinanarbitrationatthisforum.FINRAwillsendinvoicesforprocessfeestofirmsatappropriatestagesofthearbitrationprocess.
TO DETERMINE THE CORRECT SURCHARGE, USE THE “AMOUNT IN DISPUTE” FIGURE ON LINE 3, PAGE 19.
IfyouareaFIRMCLAIMANT,usethistable(Rules12901or13901)todeterminetheappropriatemembersurchargethatMUSTaccompanyyourStatementofClaimwhenitisfiledwithFINRA.IfyourclaimdoesNOTdiscloseorspecifyamonetaryclaim,thenon-refundablesurchargeis$1,900.
Member Surcharge
Amount in Dispute (exclusive of interest and expenses) Surcharge
Upto$2,500 $150
$2,500.01–$5,000 $150
$5,000.01–$10,000 $325
$10,000.01–$25,000 $450
$25,000.01–$30,000 $750
$30,000.01–$50,000 $750
$50,000.01–$100,000 $1,100
$100,000.01–$250,000 $1,700
$250,000.01–$500,000 $1,900
$500,000.01–$1,000,000 $2,475
$1,000,000.01–$5,000,000 $3,025
$5,000,000.01–$10,000,000 $3,600
Over$10,000,000 $4,025
Non-Monetary/NotSpecified $1,900
V. HEARING INFORMATION
Forclaimsof$50,000orlessunderRules12800(simplifiedcustomer/investor)and13800(simplifiedindustry):(check one)
Iamrequestingahearinginthismatter Iamnotrequestingahearinginthismatter
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FINRA ARBITRATION Submission Agreement
Claimant(s)
In the Matter of the Arbitration Between
Name(s)ofClaimant(s)
and
Name(s)ofRespondent(s)
1. Theundersignedparties(“parties”)herebysubmitthepresentmatterincontroversy,assetforthintheattachedstatementof
claim,answers,andallrelatedcrossclaims,counterclaimsand/orthird-partyclaimswhichmaybeasserted,toarbitrationin
accordancewiththeFINRABy-Laws,Rules,andCode of Arbitration Procedure.
2. Thepartiesherebystatethattheyortheirrepresentative(s)havereadtheproceduresandrulesofFINRArelatingtoarbitration,
andthepartiesagreetobeboundbytheseproceduresandrules.
3. Thepartiesagreethatintheeventahearingisnecessary,suchhearingshallbeheldatatimeandplaceasmaybedesignated
bytheDirectorofArbitrationorthearbitrator(s).Thepartiesfurtheragreeandunderstandthatthearbitrationwillbe
conductedinaccordancewiththeFINRACode of Arbitration Procedure.
4. Thepartiesagreetoabidebyandperformanyaward(s)renderedpursuanttothisSubmissionAgreement.Thepartiesfurther
agreethatajudgmentandanyinterestduethereon,maybeentereduponsuchaward(s)and,forthesepurposes,theparties
herebyvoluntarilyconsenttosubmittothejurisdictionofanycourtofcompetentjurisdictionwhichmayproperlyentersuch
judgment.
5. ThepartiesheretohavesignedandacknowledgedtheforegoingSubmissionAgreement.
ClaimantName(pleaseprint)
Claimant’sSignature DateStatecapacityifotherthanindividual(e.g.,executor,trusteeorcorporateofficer)
ClaimantName(pleaseprint)
Claimant’sSignature DateStatecapacityifotherthanindividual(e.g.,executor,trusteeorcorporateofficer)
If needed, copy this page.
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FINRA www.finra.orgOne Liberty Plaza © 2016 FINRA. All rights reserved. 165 Broadway FINRA and other trademarks of theNew York, NY 10006 Financial Industry Regulatory Authority, Inc. may not be used without permission. 16_0442.1–1/17
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