Registered Fiduciary
Firm Application –Part A
Abbreviated Name: Date:
Principal’s Name:
Firm Name:
Division:
Firm Type: RIA
Street Address:
City: State: Zip: -
Phone: Fax:
E-mail:
Web site:
Number of advisers in firm (Attach Part B for each adviser):
|If this firm is owned or controlled by another firm or individual, please explain: |
| |
|What is the principal business of the firm or individual referenced above: |
| |
Broker/Dealer (if applicable):
Firm Certifications
|Please list any certifications or other credentials that your firm holds, including the year it was first issued and the year of its expiration. An |
|example might be GIPS certification. |
| |
Payment Preference
Credit card (Enter credit card info below) Invoice (Enter billing info below) Check sent
Name on Card: Name:
MC VISA AMEX Other: Department:
Number: Address:
Expiration: City/State/Zip:
Verification Code: Phone:
Complete Part B for each adviser before submitting this application
By following the link below:
Application Part B
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Due diligence process requires that applicant:
✓ Is an RIA/IAR registered with SEC and with ADV meeting requirements for member’s practice ar慥൳牐癯摩獥攠楶敤据景欠潮汷摥敧漠楦畤楣牡⁹牰捡楴散倍潲畤散慳灭敬景挠楬湥⁴条敲浥湥獴畤楤楬敧据湡数晲牯慭据敲潰瑲畣牲湥汴⁹湩甠敳牰癩捡⁹潰楬祣散瑲晩捩瑡景椠獮牵湡散愠摮挠浯汰瑥楬瑳漠汣敩瑮䠍獡愠椠獮eas
Provides evidence of knowledge of fiduciary practices
✓ Produces samples of client agreements, due diligence and performance reports currently in use, privacy policy, certificate of insurance and complete list of clients.
✓ Has a insurance coverage that is currently in force
✓ Undergo Dalbar verification
Due diligence cost: Send completed application Part A & B to:
Firm Cost DALBAR, Inc. Manager338@
First time $3,250 600 Atlantic Ave Fax: 617-624-7200
Subsequent years $2,500 Boston MA 02110 Phone: 617-723-6400
Annual Cost per Adviser
First IAR No Charge
Each additional IAR $250
(3 digits on back for MC and VISA
4 digits on front for AMEX)
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