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ICA-CIS Application for Registration as a Certified Investment Solicitor of an investment Company Adviser/Manager and Amendments

SEC registration of a certified investment solicitor of an investment company adviser/manager under section 40 of the investment company act

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APPLICATION FOR REGISTRATION RENEWAL

COMPLIANCE OFFICER (CO)
For the year

_

(To be accomplished
in 4 copies with cover sheet;
3 copies for SEC and 1 receiving copy for the applicant)
Middle Name

First Name

Last Name

TIN
Certificate

of Registration

No.

Current Residential Address

Name of Employer Firm

Rrm's Principal Business Address
street

Branch ID#
Street

Postal Code

Province

City

Office of Employment
City

Address
Province

Postal Code

..

The above-named employer hereby makes application for the renewal registration of
the above-named individual and hereby certifies that the information contained in
his/her most recent filing of SEC Form ICA-CO is true, correct, current, accurate and
complete. All registered Compliance Officers are required to update SEC Form ICACO information by submitting amendments wherever information on file becomes
inaccurate for any reason within seven (7) days of any change to the information
previously filed.

Printed Name/Signature

Staple applicant's
2x2 B&WID picture
(with signature and
printed name at the
back)

of Company

President

Printed Name / Signature of Applicant

Dote

Subscribed and sworn to before me this __
valid identity card

day of
issued at

201_. exhibited to me his/her
on
_

Notary Public
OocNo.
Page No .. __
Book No.
Series

1.
2.

3.
4.

~
~
~
~

Four sets of duly accomplished SEC Form ICA-RCO for Compliance Officer with original signatures of the applicant
with cover sheet;
Two pieces current 2x210 picture with the signature and printed name of the applicant affixed on the dorsal side of .
each 10 picture. The 10 pictures must be attached on the application form by stapling the 10 picture on the top edge
for easy inspection of the signature and printed name on its dorsal side;
Copy of previous license; and
Payment of renewal fee- PhP1.515.00
 
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